Central Asian Journal of Medicine

COORDINATION OF INTERNAL HEMODYNAMIC DISORDERS IN PATIENTS WITH CHRONIC KIDNEY DISEASE OF DIABETIC GENESIS BY USING 2ND TYPE SODIUM-GLUCOSE COTRANSPORTER INHIBITORS

Uzakova N.I. — 2025-06-24

The article presents the results of the research on the alternative treatment of intrarenal hemodynamic disorders with the use of type 2 sodium-glucose cotransporter inhibitors in 103 patients with chronic kidney disease developed on the basis of diabetic nephropathy. Also, comparing the obtained results with the results of other authors' researches, the nephroprotective effect of the drug is once again based in detail.

ANATOMICAL STRUCTURE OF THE ADRENAL GLAND: A FORENSIC APPROACH

Rayimberdiyev S. — 2025-06-24

This article provides a systematic analysis of the anatomical and morphological features of the adrenal glands, which are of significant importance in forensic medical practice. The adrenal glands play a crucial role in maintaining the body’s homeostasis, forming responses to stress, and regulating vital metabolic processes. The article examines their location, external and internal anatomical structure, blood supply, venous drainage, lymphatic flow, and neural innervation. Furthermore, the functional connections of the adrenal glands with the central nervous system and other endocrine organs are highlighted. Particular attention is given to the diagnostic relevance of assessing the condition of the adrenal glands in forensic examinations, identifying their anatomical and topographic changes, and differentiating pathological conditions. These findings serve as an essential scientific and practical basis for in-depth forensic analysis, determining the causes of violent death, and understanding pathologies of the endocrine system.

EVALUATION OF THE EFFICACY OF AN OINTMENT CONTAINING GOOSE FAT, EXTRACT ALOE, AND BETAMETHASONE IN PRECLINICAL STUDIES FOR THE TREATMENT OF ALLERGIC DERMATITIS

Karimova F.R. — 2025-06-24

This preclinical study, based on modern scientific principles, assessed the biological safety and regenerative efficacy of a topical ointment composed of goose fat, aloe, and Betamethasone. The experiments were conducted using a full-thickness excision wound model in albino rats. The ointment demonstrated no signs of acute toxicity, with treated animals showing stable clinical behavior and body weight. Application of the formulation led to significant acceleration of wound healing, with complete closure observed by day 14. Comparative analysis indicated superior efficacy of the experimental ointment compared to standard treatments. These findings confirm the high regenerative potential and safety profile of the goose fat-based formulation and support its relevance for further clinical development.

SIGNIFICANCE AND GENO-/SEROTYPIC CHARACTERISTICS OF STREPTOCOCCUS PNEUMONIAE IN THE PATHOGENESIS OF EXACERBATIONS OF CHRONIC OBSTRUCTIVE RESPIRATORY DISEASES

Nalibaeva R.A. — 2025-06-24

Pneumococcal infection caused by Streptococcus pneumoniae remains one of the leading causes of infectious morbidity and mortality worldwide, particularly among individuals with chronic respiratory diseases. According to the World Health Organization (WHO), more than 1.6 million deaths are recorded annually due to invasive forms of pneumococcal disease, with the highest vulnerability observed in elderly patients and individuals with comorbid conditions. Chronic obstructive pulmonary diseases (COPD) significantly increase the risk of bacterial colonization and the development of severe complications associated with S. pneumoniae. The present study aims to investigate the frequency of pneumococcal detection and to analyze its serotypic and phenotypic distribution among patients with COPD, in order to assess the local serotype landscape and to inform potential adjustments in vaccination strategies.

CLINICAL PHENOMENOLOGY OF TIC DISORDERS IN CHILDREN: A SERIES OF CLINICAL CASES

Nurmatova D.A., Shomansurov Sh.Sh. — 2025-06-24

TIC disorders in children are a common neurological pathology, ranging from transient benign forms to chronic and disabling ones, such as Gilles de la Tourette syndrome (CJT). The article presents three typical clinical cases reflecting the spectrum of tic hyperkinesis: Transient tics in a 7-year-old child with complete regression on the background of non-drug correction. Chronic motor tics in a 9-year-old girl who required a combination of cognitive behavioral therapy and pharmacotherapy. Gilles de la Tourette syndrome in a 12-year-old boy with comorbid psychiatric disorders, demonstrating the need for a multidisciplinary approach. Special attention is paid to differential diagnosis, the role of stress factors, as well as modern treatment methods, including behavioral techniques (habit reversal training), pharmacotherapy (clonidine, risperidone) and psychosocial support. The importance of early intervention to improve the prognosis and quality of life of patients is emphasized.

EVALUATION OF MORPHOMETRIC PARAMETERS OF SPLEEN DEVELOPMENT IN RATS DURING EARLY POSTNATAL ONTOGENESIS

Umarova Z.Kh., Azizova F.Kh. — 2025-06-24

This article examines the characteristics of morphometric changes in the main structures of the spleen in white rats during early postnatal ontogenesis in the course of development. It reveals the patterns of formation of various structural and functional zones of this organ at different stages of early postnatal ontogenesis. It has been established that during postnatal ontogenesis, the morphological and morphometric parameters of the functional zones of the spleen in white rats undergo significant changes, which are reflected in different age-related aspects.

FEMTOSECOND-ASSISTED DEEP ANTERIOR LAMELLAR KERATOPLASTY FOR KERATOCONUS: CONTEMPORARY CLINICAL PERSPECTIVES AND OUTCOME ANALYSIS

Karimova M.Kh., Inomzhonova M.I., Abdullaeva S.I. — 2025-06-24

Femtosecond-assisted deep anterior lamellar keratoplasty (femto-DALK) represents a contemporary surgical approach for corneal pathologies that preserves the recipient's endothelium. Despite increasing clinical adoption, comprehensive analysis of femto-DALK advantages over conventional techniques requires further investigation. We conducted a retrospective analysis of 12 patients aged 18-42 years with stage III keratoconus who underwent femto-DALK between 2023-2024. Primary outcome measures included visual acuity, refractive outcomes, keratotopographic parameters, and healing characteristics. Best-corrected visual acuity of 0.6 or better was achieved in 66.67% of patients at 12 months post-operatively, with mean postoperative astigmatism of 2.1±0.9 D. Tissue interface precision was characterized by predictable residual stromal thickness of 15.6±5.3 um. Big-bubble formation was successful in 91.7% of cases, with conversion to penetrating keratoplasty required in only 8.3% of procedures. Postoperative complications were minimal, with complete anatomical apposition of Descemet's membrane confirmed by OCT in all cases. Femto-DALK demonstrates significant advantages in tissue interface precision and accelerated wound healing compared to conventional keratoplasty techniques, confirming high efficacy in achieving stable visual and refractive outcomes with enhanced surgical predictability.

ANALYSIS OF THE USE OF THE DRAINAGE IMPLANT HEALAFLOW IN SURGERY FOR PRIMARY OPEN-ANGLE GLAUCOMA

Abdurakhimova F.K. — 2025-06-24

Primary open-angle glaucoma (POAG) is a progressive optical neuropathy characterized by specific structural changes of the optic disc and visual field defects. Surgical treatment remains the gold standard when conservative therapy is ineffective, but postoperative fibrosis significantly limits the long-term efficacy of filtering surgeries. HealAFlow, an innovative injectable implant based on cross-linked hyaluronic acid, represents a promising solution to this problem. This review analyzes the current clinical data, mechanisms of action, comparative efficacy and safety of HealAFlow in POUG surgery.

COMPREHENSIVE APPROACH TO ASSESSING AND PREVENTING PRE-DEMENTIA COGNITIVE IMPAIRMENTS IN PRIMARY HEALTHCARE SETTINGS

Kamilova M.R., Rakhimbayeva G.S., Sobirova D.R. — 2025-06-24

Cognitive decline preceding dementia, often termed mild cognitive impairment (MCI), represents a critical window for intervention. Early detection and proactive management in primary healthcare can significantly reduce the progression to full-blown dementia. This study explores a comprehensive strategy for identifying and managing pre-dementia cognitive disorders within the framework of primary healthcare, emphasizing both diagnostic tools and preventive interventions.

PHYSIOLOGICAL BASIS OF HIGHER NERVOUS ACTIVITY

Mirsiddikova N.M., Ergasheva M.A., Koriyev S.A. — 2025-06-24

This article presents the results of a scientific study dedicated to the physiological foundations of higher nervous activity. Higher nervous activity refers to the process by which an organism interacts with the external environment, processes information received through sensory organs, and generates a response. The study explores the main principles of higher nervous activity, its physiological mechanisms, and biological significance.

PERIODONTAL DISEASE AND DIABETES IN UZBEKISTAN’S PUBLIC HEALTH CONTEXT

Yusupova M.M. — 2025-06-24

This paper examines the bidirectional link between diabetes and periodontal disease amid Uzbekistan’s growing burden of non-communicable diseases. Using national and international evidence, it applies a syndemic framework to reconceptualize these conditions as biologically and socially interconnected. While nutrition and infectious disease control have improved, oral complications of diabetes remain overlooked in national care strategies. The study advocates for screening, interdisciplinary training, and oral health integration into chronic disease policy.

METHODS OF DIGITIZATION IN THE APPLICATION OF MODERN MEDICAL TECHNOLOGIES

Tukhtakhodjayeva F.Sh., Sayfiddin Khoji K.Sh., Murodullayev M.N. — 2025-06-24

This article explores the transformative role of digitization in modern medical technologies, focusing on key methods such as Electronic Health Records (EHRs), telemedicine, medical imaging, wearable devices, artificial intelligence (AI), and blockchain. It examines their applications, benefits, and challenges in enhancing healthcare delivery, efficiency, and patient outcomes. Supported by a flowchart illustrating the digitization workflow and a bar chart visualizing adoption trend, the article highlights how digital solutions drive innovation in healthcare while addressing barriers like data security and implementation costs. It underscores the importance of continued investment in digital infrastructure to shape the future of medical practice.

USE OF MINIMALLY INVASIVE TECHNOLOGIES IN THE TREATMENT OF THE MUSCULOSKELETAL SYSTEM IN PATIENTS WITH POLYTRAUMA

Temurov A.A., Ziyotov L.I. — 2025-06-24

The separation of polytrauma into a separate category is associated with the severity of the injuries, which should be taken into account when providing medical care. The combination of injuries to the chest, abdomen, and musculoskeletal system is of particular interest. These combinations of traumatic injuries are accompanied not only by traumatic shock, but also by the development of hemorrhagic and peritoneal syndromes. At the same time, damage to the musculoskeletal system complicates the diagnosis and treatment of victims with damage to the internal organs of the thoracic and abdominal cavities, is a prerequisite for many life-threatening complications (shock, fatty embolism, respiratory distress syndrome, pneumonia) in the 1st and 2nd periods of traumatic diseases.
One of the most severe and frequent injuries of the musculoskeletal system is bone fractures, which occur in 90-98% of patients with multiple injuries and in 62.0-78.9% of patients with combined injuries. Mortality among victims of polytrauma varies from 3.8 to 45.3%, and the disability rate reaches from 10.3% to 43.4%.

POSTOPERATIVE MANAGEMENT OF PATIENTS AFTER BARIATRIC SURGERY

Jumaev N.A., Teshaev O.R., Kurbanov G.I., Juraev J.Z., Lim I.I., Lekomseva M.J. — 2025-06-24

Bariatric surgery represents the most effective treatment for morbid obesity, with long-term success heavily dependent on comprehensive postoperative care. This review examines evidence-based approaches to postoperative management, including nutritional support, vitamin supplementation, physical rehabilitation, and long-term follow-up protocols. Understanding the complexities of postoperative care is crucial for optimizing patient outcomes and preventing complications.

ANXIETY AND DEPRESSIVE DISORDERS IN RHEUMATOID ARTHRITIS: A CLINICAL PSYCHIATRIC STUDY

Urolova D.A. — 2025-06-24

Studies show that patients with rheumatic disease usually have the following anxiety-depressive spectrum disorders: depressive episodes (single and recurrent) of varying severity with concomitant anxiety; dysthymia (chronic depression of moderate severity); generalized anxiety disorder, as well as adjustment disorders with anxiety and depressive symptoms.

RISK FACTORS IN HYPERTENSION

Tursunkulova D.Sh. — 2025-06-24

Hypertension, or high blood pressure, is one of the most common chronic diseases in the modern world. This disease has a significant impact on the health of the heart and vascular system and can lead to many serious complications, including heart attack, stroke, kidney failure, and eye diseases. Hypertension is often called the “silent disease” because most patients do not know they have it for a long time, as there are no obvious symptoms in the early stages. Therefore, it is very important to identify and manage the risk factors for hypertension.

AFFECTIVE, COGNITIVE, AND BEHAVIORAL MANIFESTATIONS OF BURNOUT IN PRIMARY CARE PHYSICIANS

Yadgarova N.F., Kevorkova M.A. — 2025-06-24

The article discusses another contributing factor to emotional burnout syndrome-cognitive, behavioral, and emotional states. It also lists several factors influencing professional burnout observed in 120 family doctors, indicating their severity levels and the potential symptoms they may cause. The study outlines the participants' age, gender, and work experience, as well as the stages of stress, depersonalization, and burnout.

ATRIAL FIBRILLATION AS A PROGNOSTIC FACTOR AFTER BALLOON MITRAL VALVULOPLASTY USING THE INOUE TECHNIQUE: A RETROSPECTIVE ANALYSIS OF LONG-TERM OUTCOMES

Zufarov M.M., Im V.M., Khamdamov S.K. — 2025-06-24

This study presents a comparative analysis of long-term hemodynamic outcomes and survival rates in patients with rheumatic mitral stenosis (MS) who underwent balloon mitral valvuloplasty (BMV) using the Inoue technique, considering the presence of atrial fibrillation (AF) and sinus rhythm (SR). A total of 358 patients were included and divided into AF (n=115) and SR (n=243) groups. Comprehensive assessments of clinical characteristics, echocardiographic parameters, and the incidence of adverse cardiovascular events as well as survival using the Kaplan–Meier method were performed. The results demonstrated that BMV effectively improved hemodynamic parameters in both groups, significantly increasing mitral valve area and reducing the transmitral gradient. However, patients with AF were older, exhibited more pronounced left atrial dilation, and had reduced left ventricular systolic function. Clinical outcomes in this group were less favorable, with higher mortality rates (19.1% vs. 0% in the SR group), increased hospitalizations, and complications. Event-free survival remained stable in the SR group throughout the follow-up period, whereas a significant decline was observed in the AF group. These findings emphasize the importance of early BMV intervention in patients with sinus rhythm to prevent the development of atrial fibrillation and improve prognosis. Patients with AF require prolonged follow-up and a comprehensive therapeutic approach to reduce the risk of adverse outcomes. The results are critical for optimizing the management strategy of rheumatic mitral stenosis, taking into account the arrhythmic status of the patient.

LIVER MORPHOGENESIS IN FIRST-GENERATION RATS BORN TO FEMALES WITH INDUCED DIABETES MELLITUS DURING EARLY POSTNATAL ONTOGENESIS

Azizova F.Kh., Ubaydullayeva M.A. — 2025-06-24

Background: The liver plays a critical role in metabolism, detoxification, hematopoiesis, and immune defense. The impact of maternal diabetes mellitus on liver histogenesis during early postnatal ontogenesis remains insufficiently studied, despite the increasing prevalence of diabetes among women of reproductive age and data indicating its effect on the development of fetal parenchymal organs. Methods: The experimental study was conducted on 50 white outbred female rats (25 control, 25 experimental) with diabetes induced by a single intraperitoneal injection of alloxan (13 mg/100 g). Offspring (n=253) were examined on postnatal days 3, 7, 14, 21, and 30. Histological liver examination was performed using hematoxylin and eosin staining, and morphometric analysis was carried out with QuPath 0.5.1 software. Parameters assessed included lobule area and diameter, hepatocyte and nuclear dimensions, mitotic count, nuclear-cytoplasmic ratio, and fibrotic changes. Results: In the control group, liver tissue demonstrated progressive formation of beam and vascular architecture, bile duct maturation, and a reduction in mitotic activity by day 30. The experimental group exhibited disorganized beam structure, persistent cytoplasmic vacuolization in hepatocytes, delayed development of portal tracts, and increased numbers of mitoses and binuclear cells. Morphometry showed significantly larger lobule and hepatocyte dimensions and moderate collagen accumulation in portal areas (p<0.001). Conclusion: Maternal diabetes mellitus has a significant negative effect on liver morphogenesis in offspring during early postnatal ontogenesis, manifested by delayed differentiation, architectural disorganization, and early signs of fibrosis.

REVIEW OF LITERATURE ON THE SPECIFICITY OF GENERAL PATHOMORPHOLOGICAL CHANGES IN SATELLITE STRUCTURES UNDER THE INFLUENCE OF CORONAVIRUS

Rasulov H.A. — 2025-06-24

Viral infections observed during pregnancy can have a specific impact on the body, leading to various negative outcomes at different stages of pregnancy. This necessitates an understanding of the pathological processes occurring in the placenta (maternal-placental system). Women suffering from viral infections such as herpes, hepatitis, rubella, and measles experience changes in the placenta, which have been studied in this context. In our study, special attention is given to the morphological changes in the placenta resulting from the coronavirus infection (SARS-CoV-2), which has shocked the entire world. The main morphological changes observed in the placenta during COVID-19 infection are presented.

KEY BIOPHYSICAL AND BIOCHEMICAL CONDITIONS FOR ORGAN CULTIVATION USING INFORMATION TECHNOLOGY

Tursunmetov I.R., Goyibnazarov R.B., Ganiev S.F. — 2025-06-24

The donor organ shortage is an acute global problem: many patients are dying waiting for a transplant, and the number of people on waiting lists is growing. Hope comes from regenerative medicine: growing tissues and organs from the patient’s own cells. The article describes the key biophysical and biochemical conditions of organ cultivation, as well as the application of information technology.

ECG CHANGES IN ACUTE MYOCARDIAL (AMI)

Kholboboyeva Sh.A. — 2025-06-24

Acute myocardial infarction (AMI) is one of the most critical cardiovascular emergencies, primarily caused by sudden occlusion of coronary arteries, leading to ischemia and necrosis of heart muscle tissue. The electrocardiogram (ECG) is the most accessible, rapid, and reliable diagnostic tool used to detect and monitor AMI.
This article reviews the characteristic ECG changes seen in AMI, including ST-segment elevation, ST-segment depression, pathological Q wave formation, and T wave inversion. It distinguishes between ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), explaining their diagnostic criteria and ECG features.

THE IMPACT OF VITAMIN D DEFICIENCY ON THE MANIFESTATIONS OF METABOLIC SYNDROME IN WOMEN OF REPRODUCTIVE AGE

Khasanova G.Kh., Tukhtaeva N.Kh. — 2025-06-24

This prospective study included 150 outpatient women aged 16–41 years with metabolic syndrome (MS) and 25-hydroxyvitamin D [25(OH)D] levels below 30 nmol /L. All participants underwent anthropometry, bioimpedance measurement of body composition, assessment of carbohydrate and lipid metabolism parameters, and genotyping of FokI and ApaI polymorphisms of the VDR gene. The treatment protocol included daily intake of cholecalciferol at a dose of 10,000 IU, myo- inositol 4 g, and a low-carbohydrate high-fat (LCHF) diet against the background of standard MS therapy with metformin.
After 12 weeks, the median 25(OH)D value reached the reference level; body mass index decreased by 7.8% (p < 0.01), waist circumference by 6.5% (p < 0.01). There was a significant decrease in HOMA-IR (–32%), triglyceride (–18%) and LDL (–11%) concentrations with a simultaneous increase in HDL (+9%). The most pronounced metabolic improvement was noted in carriers of the minor FokI -T and ApaI -C alleles.
For the first time in the population of Uzbekistan, a connection between vitamin D deficiency and MS with VDR gene polymorphisms was established, and the high efficiency of complex nutraceutical correction carried out against the background of an LCHF diet was confirmed. Based on the data obtained, a screening algorithm was developed that involves mandatory determination of 25(OH)D and genetic risk markers, which allows for personalization of therapy and increases its clinical and socio-economic effectiveness.

IMMUNE STATUS IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Gulyamov M.Kh. — 2025-06-24

The purpose of the study was to conduct a comparative analysis of the immune status of patients with benign prostatic hyperplasia (BPH) after various surgical interventions: endoscopic ablation of the prostate (EAP), transurethral resection of the prostate (TUR) and traditional adenomectomy. Eighty patients were included in the study: 20 underwent EAP, 20 underwent TUR, and 40 underwent traditional adenomectomy. The indices of cellular and humoral immunity in the preoperative and postoperative periods were studied. Differences in the immune response of the organism depending on the applied method of treatment were revealed.

ASSESSMENT OF REHABILITATION EFFECTIVENESS FROM THE PATIENT'S PERSPECTIVE BEFORE AND AFTER TOTAL HIP AND KNEE ARTHROPLASTY

Tilyakov Kh.A. — 2025-06-24

Amid a rapid increase in total hip and knee arthroplasty (THA and TKA) procedures in Uzbekistan, this study aimed to identify discrepancies between patients’ expectations prior to surgery and their actual experiences postoperatively.

PREDICTION OF THE RISK OF DEVELOPING SECONDARY EMPTY SELLA SYNDROME

Shagazatova B.Kh., Artikova D.M. — 2025-06-24

A prognostic assessment of risk factors for the development of secondary empty sella syndrome with the formation of risk groups was performed using 51 individuals as an example. Risk factors for the development of secondary ESS syndrome include a history of treatment of pituitary micro- and macroadenomas with dopamine agonists, the number of pregnancies up to 3, then in descending order normal body weight, age of patients from 30 to 40 years, men, and headaches.

DISCUSSION ON OPTIMAL TREATMENT STRATEGIES FOR OVARIAN ENDOMETRIOSIS

Nadjmitdinova D.A., Asrankulova D.B. — 2025-06-24

Ovarian endometriosis is a prevalent gynecological condition associated with chronic pelvic pain, infertility, and decreased ovarian reserve. Despite its frequency, the optimal surgical approach remains controversial due to variability in diagnostic criteria and the potential risks associated with operative interventions. According to global estimates, endometriosis affects approximately 10–15% of women of reproductive age, with ovarian endometriomas observed in up to 44% of these cases. The burden of disease is particularly significant due to diagnostic delays, often averaging 7–10 years from symptom onset to confirmed diagnosis.