JOURNAL OF EDUCATION AND SCIENTIFIC MEDICINE

SIMULATION-BASED MEDICAL EDUCATION

Sh.A. Boymurodov — 2025-06-01

Simulation-based education has become an integral part of modern medical training, offering a safe and controlled environment for developing clinical competencies. Advanced simulation technologies allow students to train for both emergency and routine clinical situations without risk to real patients, fostering confidence, motor coordination, and teamwork.

This article provides an overview of the simulation-based education model and presents the experience of Tashkent State Medical University (TSMU) in developing one of the most advanced simulation centers in the region. The center, aligned with leading global standards including those of the University of Central Florida (USA), supports core disciplines such as surgery, internal medicine, pediatrics, and intensive care. The article highlights the structure, equipment, training modules, and the broader educational and patient safety implications of simulation-based learning.

This is a continuation of our publications in this direction [1-18]. The authors hope that this message will further explain the possibilities of the modern educational process in medicine.

Keywords: medical education, simulation education, Tashkent State Medical University

DEVELOPMENT AND CLINICAL VALIDATION OF AN IMMUNOLOGICAL PREDICTION MODEL FOR POSTOPERATIVE COMPLICATIONS FOLLOWING TRANSPEDICULAR FIXATION IN PATIENTS WITH SPONDYLOLISTHESIS

B.Z. Khamdamov — 2025-06-03

ANATOMICAL PREDICTORS IN HERNIA RECURRENCE

F.M. Abdurakhmanov — 2025-06-07

Recurrence after ventral hernia repair remains a clinically significant and economically burdensome complication, particularly among elderly patients. In recent years, increasing attention has been paid to anatomical and morphometric factors that influence the stability of abdominal wall reconstruction. This review summarizes current evidence on anatomical predictors of recurrence, including aponeurosis thickness, diastasis recti, defect size and configuration, and mesh fixation zones. Emphasis is placed on the role of high-resolution imaging, intraoperative morphometry, and tissue quality evaluation in elderly individuals with recurrent hernias. Several risk stratification models incorporating these factors have been proposed, with promising results in reducing recurrence and optimizing surgical outcomes. Anatomical predictors should be considered a cornerstone in developing individualized, anatomy-informed surgical strategies for high-risk patients.

Keywords: ventral hernia, recurrence, aponeurosis, morphometry, abdominal wall, elderly patients, anatomical risk factors

PERIOPERATIVE IMMUNOSUPPRESSION IN CANCER PATIENTS

B.Z. Khamdamov — 2025-06-07

Surgical stress and anesthesia are well-documented triggers of transient immunosuppression in cancer patients, potentially promoting tumor progression and metastasis during the perioperative period. Different anesthetic techniques—such as general anesthesia with volatile agents, total intravenous anesthesia (TIVA), regional blocks, and opioid-based analgesia—exert variable effects on immune function. This review summarizes current evidence on how anesthetic modalities influence cellular and humoral immunity in oncologic surgery. Key mechanisms discussed include effects on natural killer (NK) cell activity, cytokine release, neutrophil function, and regulatory T cell populations. The review also examines how these immunological changes may affect oncologic outcomes, including recurrence and survival. Understanding these effects is critical to tailoring anesthesia protocols that minimize immunosuppression and support host defense during the perioperative window.

Keywords: Cancer, perioperative immunosuppression, anesthesia, TIVA, immune function, surgical oncology

EARLY DIAGNOSIS AND SURGICAL TREATMENT OF DEEP PARAPROCTITIS IN DIABETIC PATIENTS

A.L. Kasimov — 2025-06-07

Paraproctitis remains a significant surgical pathology, often complicated in the presence of systemic diseases such as diabetes mellitus (DM). Deep forms of paraproctitis in diabetic patients are characterized by atypical clinical manifestations, rapid progression of the infectious process, and a high risk of systemic complications. Early diagnosis and the selection of an adequate surgical approach are critical in improving outcomes for this vulnerable patient cohort. This review article summarizes the current literature and clinical experience regarding the diagnostic methods, classification systems, imaging modalities, and surgical tactics used in managing deep paraproctitis in patients with diabetes. Particular attention is paid to the peculiarities of wound healing, glycemic control, and perioperative management. Modern approaches, including minimally invasive drainage, staged surgery, and the role of antibacterial therapy, are discussed. The integration of a personalized treatment algorithm based on the severity of the inflammatory process, metabolic status, and comorbidity profile is emphasized as a promising direction in the optimization of care.

POSTOPERATIVE COMPLICATIONS IN GENERALIZED PERITONITIS

O.U. Rakhimov — 2025-06-07

Generalized peritonitis remains a critical challenge in abdominal surgery due to its high morbidity and mortality, especially in the early postoperative period. The complexity of immune responses, intra-abdominal contamination, and systemic inflammation contributes to a high risk of postoperative complications. This review focuses on current approaches to predicting and preventing these complications, particularly the role of immunological markers and immunomodulatory interventions. The use of scoring systems, laboratory predictors, intraoperative findings, and early immune profiling is discussed as a means to stratify risk and guide therapy. Immunoprophylaxis strategies, including perioperative immunonutrition, cytokine modulation, and selective immunotherapy, are analyzed in the context of evidence-based practice. The article highlights the importance of integrated prognostic-immunological models for improving outcomes in patients undergoing surgery for generalized peritonitis.

DETERMINING THE ROLE OF ANGIOGENIC FACTORS IN THE PREDICTION OF PREECLAMPSIA

R.S. Navruzova — 2025-06-07

Preeclampsia is a major cause of maternal and perinatal morbidity and mortality worldwide. Its pathogenesis is complex and multifactorial, involving abnormal placentation, immune dysfunction, and endothelial injury. Recent advances have emphasized the critical role of angiogenic imbalance in the development and progression of preeclampsia. This review evaluates the predictive value of angiogenic biomarkers—including placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and soluble endoglin (sEng)—in identifying women at risk for preeclampsia. It summarizes current evidence on the pathophysiological significance of these factors, their temporal expression patterns in pregnancy, and their integration into clinical risk models. The potential utility of angiogenic biomarkers in early screening, diagnosis, and therapeutic stratification is critically discussed. Incorporating angiogenic profiling into prenatal care could significantly improve the early prediction and management of preeclampsia.

INDIVIDUALIZED SURGICAL STRATEGY IN INFECTED PANCREATIC NECROSIS WITH DIABETES

D.M. Hakimov — 2025-06-08

Infected pancreatic necrosis (IPN) is one of the most severe and life-threatening complications of acute necrotizing pancreatitis. In patients with diabetes mellitus, the clinical course of IPN is aggravated by immune dysfunction, microvascular complications, and metabolic instability. Traditional surgical approaches often fail to account for the individual variability in disease progression, infection severity, and patient resilience. This review aims to provide an overview of current literature on the role of personalized surgical strategies in the management of IPN in diabetic patients. Emphasis is placed on early risk stratification, imaging-based staging, timing and modality of intervention, and perioperative glycemic control. Advances in minimally invasive necrosectomy, step-up approaches, and multidisciplinary decision-making are discussed in the context of diabetic physiology. The need for individualized treatment algorithms that integrate clinical, biochemical, and radiological data is highlighted as a cornerstone of modern surgical practice in IPN.

SURGICAL TREATMENT OF HIATAL HERNIA

A.Z. Isomutdinov — 2025-06-09

Surgical treatment remains the mainstay of management for symptomatic or complicated hiatal hernias. Advances in minimally invasive techniques have improved postoperative recovery and reduced morbidity, but the optimal surgical approach continues to evolve. This review discusses current indications for surgery, procedural selection based on hernia type, and technical considerations in laparoscopic repair, including cruroplasty, fundoplication, and mesh reinforcement. Attention is given to preoperative evaluation, recurrence prevention, and the management of complex or recurrent hernias. Outcomes, complications, and quality-of-life data are critically reviewed, with emphasis on tailoring surgical strategies to patient-specific anatomy and risk profile.