Vol. 18 Issue 2 (2025) - Vestnik Sovremennoi Klinicheskoi Mediciny

Abstract. Introduction. Upper extremity tunnel neuropathies are a common cause of pain syndrome and functional impairments in patients of various ages, requiring a comprehensive diagnostic approach using modern imaging techniques. Due to its accessibility, safety, and high information content, ultrasound examination allows an accurate assessment of soft tissue structures and the degree of nerve compression. The aim of this study was to comprehensively investigate the diagnostic value of ultrasound examination in upper extremity tunnel neuropathies, as well as to evaluate the ultrasound examination eﬃ ciency for detecting the nerve compression degree and for dynamically monitoring patients’ conditions. Materials and Methods. The study was conducted at the National Medical Center from January, 2023 to December, 2024. It included 50 patients (28 men and 22 women) aged 25 to 65 years with clinical manifestations of upper extremity tunnel neuropathies (numbness, paresthesia, decreased muscle strength, and pain). Inclusion criteria were the presence of a confi rmed nerve compression syndrome and the absence of any acute infl ammatory diseases. Patients underwent a comprehensive examination, including medical history collection, physical examination, electromyography, magnetic resonance imaging, and ultrasound examination of the upper extremity nerves. Ultrasound examination was performed using a high-frequency linear transducer (7–15 MHz), with assessment of nerve thickness in the compression zone and proximally, echogenicity, edema, and nerve mobility. Increase in the nerve transverse diameter by more than 20% compared to the proximal segment was considered a diagnostically signifi cant fi nding. Comparison was made with electromyography and magnetic resonance imaging data, assessing amplitude, nerve conduction velocity, and the condition of surrounding tissues. Statistical analysis was performed in SPSS 25.0 using Student’s t-test, with a signifi cance level of p<0.05. Results and Discussion. Patients were divided into two groups: One with carpal tunnel syndrome (n=30) and one with cubital tunnel syndrome (n=20). A comprehensive examination included ultrasound examination, Doppler sonography, and magnetic resonance imaging, which revealed nerve thickening, decreased echogenicity and blood fl ow, and changes in structure on T2-weighted images. Electromyography showed a decrease in nerve conduction velocity, correlating with nerve thickening and decreased blood fl ow, which confi rms the importance of a comprehensive approach to diagnosing tunnel neuropathies. Conclusions. A comprehensive approach to the diagnosis of upper extremity tunnel neuropathies using ultrasound examination, Doppler sonography, and magnetic resonance imaging provides high accuracy in assessing nerve compression, vascular components, and structural changes. The fi ndings confi rm the importance of combining these methods to optimize diagnostics and stratify patients.

Keywords: ultrasound, MRI, tun nel neuropathies of the upper limbs, Doppler imaging.

For citation: Abduqodirova, M.B.; Khodjibekova, Yu.M.; Abduqodirov, E.I. Comprehensive assessment of ultrasound capabilities in diagnosing upper limb tunnel neuropathies. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 7-11. DOI: 10.20969/VSKM.2025.18(2).7-11.

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13. Hsu RT, et al. Advanced Imaging Techniques in Nerve Compression Syndromes: Role of Doppler Ultrasound and MRI. Neuroimaging Clinics of North America. 2024; 34(1): 45-56. DOI: 10.1016/j.nicna.2023.09.004

УДК: 616.716-002-073 DOI: 10.20969/VSKM.2025.18(2).12-17

Comparative diagnostic radiology features of chronic osteomyelitis and maxillary osteonecrosis

Mirshod J. Atavullayev1, Adkham I. Khasanov2, Farrukh G. Sabirov3, Elmira B. Baykhodjayeva1

1Bukhara State Medical Institute named after Abu Ali ibn Sino, 23 Gijduvanskaya str., 100118 Bukhara, Uzbekistan

2Tashkent State Dental Institute, 103 Maxtumkuli str., Yashnabad District, 100047 Tashkent, Uzbekistan

3Fergana Medical Institute of Public Health, 2A Yangi Turon Street, 150100 Fergana, Uzbekistan

Abstract. Introduction. Recent decades have seen changes in the structure of infl ammatory diseases of the maxillofacial region associated with the non-medication use of synthetic drugs, which leads to the development of atypical forms of osteomyelitis with aggressive destruction of bone tissue. Comparative analysis of diagnostic radiology techniques, including CT and MRI, allows us to identify specifi c signs of chronic osteomyelitis and osteonecrosis of the maxilla, which is of key importance for early diagnosis and choice of treatment tactics. The aim of the study was to investigate the clinical features of the course of and perform a comparative analysis of the diagnostic radiology data in chronic osteomyelitis and osteonecrosis of the maxilla, developed as a result of exposure to various pharmacological drugs, as well as during radiation therapy. Materials and Methods. The study included 57 patients with chronic infl ammatory lesions of the maxilla developed under the infl uence of pharmacological drugs or radiation therapy, who underwent a comprehensive clinical and laboratory examination and dynamic follow-up from 1 month to 4 years. Digital radiography and multispiral CT with 3D-reconstruction were used to assess the structural changes in bone tissue, which allowed detailed visualization of pathological processes. Results and Discussion. The study included 57 patients with chronic osteomyelitis (n=38, 66.7%) and osteonecrosis (n=19, 33.3%) of the upper jaw, accompanied by prolonged pain, tooth mobility, bone exposure, and purulent discharge. Computed tomography revealed that osteomyelitis was characterized by diﬀ use rarefaction of the bone structure (89.5%), zones of osteolysis with alternating areas of sclerosis (76.3%) and sequestrations (65.8%), whereas osteonecrosis was more often characterized by well-defi ned zones of necrosis (89.5%), pronounced osteosclerosis (78.9%), and no diﬀ use bone rarefaction (73.7%). Conclusions. Computed tomography has a high diagnostic value in diﬀ erentiating chronic osteomyelitis and osteonecrosis of the maxilla, making it possible to detect characteristic destructive changes in bone tissue. Osteomyelitis is characterized by diﬀ use rarefaction and alternating zones of osteolysis and sclerosis, whereas osteonecrosis is typifi ed by well-defi ned limited areas of necrosis and pronounced osteosclerosis.

Keywords: CT, chronic osteomyelitis, maxillofacial region, osteonecrosis.

For citation: Atavullaev, M.J.; Khasanov, A.I.; Sabirov, F.G.; Baykhodjaeva, E.B. Comparative diagnostic radiology features of chronic osteomyelitis and maxillary osteonecrosis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 12-17. DOI: 10.20969/VSKM.2025.18(2).12-17.

REFERENCES

1. Basin E, Medvedev Yu, Polyakov K. Drug-Induced Osteonecrosis of the Jaws. Vrachebnoe Delo. 2014; 12: 35-37.

2. Исмаилова М.Х., Юнусова Л.Р., Хайдарова Г.Б., Абдуллаева Л.Ш. Мультимодальная визуализация осложнений челюстно-лицевой области у пациентов с сахарным диабетом, перенесших Covid-19 // Вестник современной клинической медицины. – 2023. – Т.16, Прил. 2. - С.19-23. [Ismailova MH, Yunusova LR, Khaydarova GB, Abdullaeva LS. Multimodalnaya vizualizatsiya oslojneniy chelyustno-litsevoy oblasti u patsientov s saxarnim diabetom, perenesshix Covid-19 [Multimodal imaging of complications in the maxillofacial area in patients with diabetes mellitus who have undergone COVID-19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine]. 2023; (16) (suppl 2): 19-23. DOI: 10.20969/VSKM.2023.16(suppl.2).19-23

3. Юнусова Л.Р., Икрамов Г.О., Халманов Б.А., Сувонов К.Ж. МСКТ диагностика остеомиелита верхней челюсти, у пациентов перенесших COVID-19. Вестник современной клинической медицины. – 2022. – Т.15, вып.5. – С.81-85. [Yunusova LR, Ikramov GO, Halmanov BA, Suvanov KJ. MSKT diagnostika osteomielita verhnej chelyusti, u pacientov perenesshih COVID-19 [MSCT diagnosis of osteomyelitis of the upper jaw, in patients who underwent COVID-19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine.] 2022; (15) 5: 81-85. DOI: 10.20969/VSKM.2022.15(5).81-85

4. Исраилова М.Н., Юнусова Л.Р., Ходжибекова Ю.М., Юлдашева Д.Ю. Роль МСКТ и МРТ в дифференциальной диагностике осложнений средней зоны лица у пациентов с патологией грибковой этиологии // Вестник современной клинической медицины. – 2023. – Т.16, Прил. 2. – С.24-28. [Israilova MN, Yunusova LR, Khodjibekova YM, Yuldasheva DY. Rol MSKT i MRT v diﬀ erentsialnoy diagnostike oslojneniy sredney zoni litsa u patsientov s patologiey gribkovoy etiologii [The role of MSCT and MRI in the diﬀ erential diagnosis of complications in the midface in patients with fungal etiology]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine]. 2023; 16 (suppl 2): 24-28. DOI: 10.20969/VSKM.2023.16(suppl.2).24-28

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УДК: 616.718-002.77:616.24-002.77+616.831.4 DOI: 10.20969/VSKM.2025.18(2).18-23

Dynamic evaluation of multislice computed tomography findings in the treatment of maxilla osteomyelitis in post-COVID-19 patients

Elmira B. Baykhodjayeva1, Adkham I. Khasanov1, Mirshod J. Atavullayev2, Farrukh G. Sabirov3

1Tashkent State Dental Institute, Tashkent State Dental Institute, 103 Maxtumkuli Street, Yashnabad District, 100047 Tashkent, Uzbekistan

2Bukhara State Medical Institute named after Abu Ali ibn Sino, Bukhara State Medical Institute named after Abu Ali Ibn Sino, 23 Gijduvanskaya Street, 200118 Bukhara, Uzbekistan

3Fergana Medical Institute of Public Health, 2A Yangi Turon Street, Fergana 150100, Uzbekistan

Abstract. Introduction. Upper jaw osteomyelitis is a serious condition requiring a comprehensive approach to diagnosis and treatment. It can develop as a result of infectious diseases, trauma, and in the context of diseases that weaken the immune system. Recently, special attention has been paid to patients who have had COVID-19, as the virus can contribute to the development of complications in the maxillofacial region, including osteomyelitis. The aim of the study was to evaluate the dynamics of osteomyelitis of the upper jaw in post-COVID-19 patients, using multislice computed tomography, and to investigate the eﬀ ectiveness of diﬀ erent treatment methods based on the findings of dynamic multislice computed tomography studies. Materials and Methods. The study included 6 post-COVID-19 patients diagnosed with upper jaw osteomyelitis. All patients were treated in a hospital and dynamically monitored using multislice computed tomography. Initial examination was performed 3-5 days after the beginning of treatment, and subsequent examinations were performed after 14 and 30 days. Disease dynamics was assessed based on changes in inflammatory volume, bone structure, and surrounding tissues, and on response to therapy. Results and Discussion. At the time of the fi rst multislice computed tomography examination, all patients showed characteristic signs of upper jaw osteomyelitis: Osteoporosis, necrosis foci, thickening of soft tissues, and oedema. After 7 days of treatment in 4 cases, there was a decrease in the size of the infl ammatory focus, improvement of bone tissue condition, and partial restoration of bone structure. In two cases, deterioration was observed, with an increase in the infl ammation area and development of complications, which required treatment approach corrections. After 14 days of treatment, 5 patients continued to improve, and one patient had a stabilized state without deterioration. Conclusions. Dynamic evaluation of multislice computed tomography fi ndings allows the eﬀ ective monitoring of the maxilla osteomyelitis treatment process in post-COVID-19 patients. Multislice computed tomography is an important technique for detecting changes in the bone and soft tissue structure, as well as for evaluating the eﬀ ectiveness of treatment approaches. Multislice computed tomography performed over time helps timely correct treatment and avoid complications.

Keywords: multislice computed tomography, MSCT, prognosis, maxillofaci al region, complications, COVID-19.

For citation: Baykhodjaeva, E.B.; Khasanov, A.I.; Atavullaev, M.J.; Sabirov, F.G. Dynamic evaluation of multislice computed tomography fi ndings in the treatment of maxilla osteomyelitis in post-COVID-19 patients. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 18-23. DOI: 10.20969/VSKM.2025.18(2).18-23.

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11. Исмаилова М.Х., Юнусова Л.Р., Хайдарова Г.Б., Абдуллаева Л.Ш. Мультимодальная визуализация осложнений челюстно–лицевой области у пациентов с сахарным диабетом, перенесших Covid–19. Вестник современной клинической медицины. – 2023. – Т.16, Прил. 2. – С.19–23. [Ismailova MH, Yunusova LR, Khaydarova GB, Abdullaeva LS. Multimodalnaya vizualizatsiya oslojneniy chelyustno–litsevoy oblasti u patsientov s saxarnim diabetom, perenesshix Covid–19 [Multimodal imaging of complications in the maxillofacial area in patients with diabetes mellitus who have undergone COVID–19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine]. 2023; 16 (suppl 2): 19–23. DOI: 10.20969/VSKM.2023.16(suppl.2).19–23

12. Юнусова Л.Р., Икрамов Г.О., Халманов Б.А., Сувонов К.Ж. МСКТ диагностика остеомиелита верхней челюсти, у пациентов перенесших COVID–19. Вестник современной клинической медицины. – 2022. – Т.15, вып.5. – С.81–85. [Yunusova LR, Ikramov GO, Halmanov BA, Suvanov KJ. MSKT diagnostika osteomielita verhnej chelyusti, u pacientov perenesshih COVID–19 [MSCT diagnosis of osteomyelitis of the upper jaw, in patients who underwent COVID–19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine.] 2022; (15) 5: 81–85. DOI: 10.20969/VSKM.2022.15(5).81–85

13. Исраилова М.Н., Юнусова Л.Р., Ходжибекова Ю.М., Юлдашева Д.Ю. Роль МСКТ и МРТ в дифференциальной диагностике осложнений средней зоны лица у пациентов с патологией грибковой этиологии // Вестник современной клинической медицины. – 2023. – Т.16, Прил. 2. – С.24–28. [Israilova MN, Yunusova LR, Khodjibekova YM, Yuldasheva DY. Rol MSKT i MRT v diﬀ erentsialnoy diagnostike oslojneniy sredney zoni litsa u patsientov s patologiey gribkovoy etiologii [The role of MSCT and MRI in the diﬀ erential diagnosis of complications in the midface in patients with fungal etiology]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine]. 2023; (16) (suppl 2): 24–28. DOI: 10.20969/VSKM.2023.16(suppl.2).24–28

УДК: 616.8-009.836:615.8 DOI: 10.20969/VSKM.2025.18(2).24-28

Clinical aspects and differentiated therapy strategies for idiopathic form of restless legs syndrome

Umida G. Yodgorova1, Malika M. Raimova1, Saodat K. Sobirova1, Muborak B. Abdullaeva1, Gavhar S. Kendjayeva1, Nigorakhon A. Okiljonova1

1Tashkent State Dental Institute, 103 Mahtumkuli Street, 100047 Tashkent, Uzbekistan

Abstract. Introduction. Restless legs syndrome is a disease with a polyetiological nature, including genetic, neurological and metabolic factors. Its prevalence is about 5-10% in the adult population. The severity of symptoms varies from mild forms to severe conditions that signifi cantly reduce the quality of life of patients. The aim of this study to evaluate clinical manifestations, dynamics of laboratory parameters and eﬀ ectiveness of therapy in patients with idiopathic restless legs syndrome. Material and Methods. The study involved 51 patients (17 men and 34 women), in whom clinical manifestations, blood biochemical parameters, coagulogram, vitamin and hormone levels, immunological markers were studied, and the impact of the disease on the quality of life and psycho-emotional state were assessed. Results and Discussion. The study analyzed data from 51 patients with idiopathic restless legs syndrome, including 17 men and 34 women. Key factors aﬀ ecting symptom severity were identifi ed, including iron defi ciency (49% of patients), vitamin D defi ciency (70.5%), vitamin B12 and folic acid defi ciency (37.2%), magnesium and calcium deficiency (52.9%), and hypothyroidism (29.41%). Statistical analysis showed signifi cant correlations between ferritin, vitamin D, and IL-6 levels and the severity of the disease symptoms (p < 0.05). Complex therapy aimed at correction of the identifi ed defi ciencies led to the improvement of the patients’ condition, reduction of infl ammatory markers, and decrease in the severity of symptoms. Conclusions. The study demonstrates the key role of vitamin and mineral balance, infl ammatory, and hormonal factors in the pathogenesis of restless legs syndrome. Correction of iron, vitamin D, and magnesium defi ciency signifi cantly improves the clinical manifestations of the disease, and taking into account sex diﬀ erences allows increasing the therapy eﬀ eciency. A comprehensive and individualized approach to treatment provides a signifi cant reduction in symptomatology and improvement in the quality of life of patients.

Keywords: restless legs syndrome, iron defi ciency, vitamin D, magnesium, infl ammatory markers, hormone balance, personalized therapy, quality of life, sex diﬀ erences, integrated approach.

For citation: Yodgarova, U.G.; Raimova, M.M.; Sobirova, S.K.; et al.Clinical aspects and diﬀ erentiated therapy strategies for idiopathic form of restless legs syndrome. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 24-28. DOI: 10.20969/VSKM.2025.18(2).24-28.

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9. Zhou J, Eﬃ ong U. Isolated Pyridoxine Defi ciency Presenting as Muscle Spasms in a Patient With Type 2 Diabetes: A Case Report and Literature Review. Am J Med Sci. 2021; 361: 791–794.

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УДК: 616.12-008.331.1-071.1:616. 153.96 DOI: 10.20969/VSKM.2025.18(2).29-34

Stratification algorithm for persons being at cardiovascular progression risk from among patients with essential arterial hypertension after 12-month follow-up, and its validation

Ekaterina V. Zhivchikova1, Ekaterina A. Polunina2, Olga S. Polunina2, Tatiana V. Prokofyeva2

1Astrakhan Clinical Hospital, Southern District Medical Center of the Federal Medical and Biological Agency of Russia,

13/14 M. Gorky str., 414000 Astrakhan, Russia

2Astrakhan State Medical University, 121 Bakinskaya, 414000 Astrakhan, Russia

Abstract. Introduction. The development and progression of essential arterial hypertension is caused by diﬀerent pathogenetic factors/predictors, and the study thereof opens up the prospect of improving the diagnosis, treatment and prevention. Aim. To develop a personalized algorithm to stratify persons being at cardiovascular progression risk from among patients with stage I arterial hypertension after 12-month follow-up and to validate it. Material and Methods. A cohort of patients with stage I arterial hypertension and uncontrolled course (n=90) was selected for the study. After 12 months, patients were divided into two subgroups based on the cardiovascular risk dynamics: With increased cardiovascular risk and with constant cardiovascular risk. Klotho protein levels were analyzed in blood serum by enzyme immunoassay. The statistical analysis was carried out using the IBM SPSS Statistics 26.0 program (USA). Results and Discussion. The fi nal model of classifi cation tree includes the following predictors: Presence of concomitant pathology, body mass index, and Klotho protein levels. Based on the classifi cation tree obtained, we have created an algorithm that allows the stratifi cation of patients with stage I arterial hypertension and a high probability of cardiovascular risk progression after 12 months. To assess the quality of our proposed algorithm, it was validated based on a sample of 48 patients. Patients were randomly selected according to inclusion and non-inclusion criteria. When validating the algorithm, 43 out of 48 cases were correctly recognized, that is, the percentage of correct predictions was 89.6%. Conclusions. An algorithm was developed to stratify persons being at risk of cardiovascular progression among patients with stage I arterial hypertension after 12-month follow-up with the sensitivity of 93.3% and specifi city of 100.0%. The correct forecast for the developed algorithm validation was 89.6%.

Keywords: essential arterial hypertension, cardiovascular risk, prognosis, personalized algorithm

For citation: Zhivchikova, E.V.; Polunina, E.A.; Polunina, O.S.; Prokofi eva, T.V. Stratifi cation algorithm for persons being at cardiovascular progression risk from among patients with essential arterial hypertension after 12-month follow-up, and its validation. The Bulletin of Contemporary Clinical M edicine. 2025, 18 (2), 29-34. DOI: 10.20969/VSKM.2025.18(2).29-34.

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УДК 616-085+616-071 DOI: 10.20969/VSKM.2025.18(2).35-40

Association of the triglyceride-glucose index and its modifications with metabolic syndrome in young people

Elena V. Korneeva1, Mikhail I. Voevoda2

1Surgut State University, 1 Lenin Ave., 628412 Surgut, Russia.

2Federal Research Center for Fundamental and Translational Medicine, 2 Timakova str., 630117 Novosibirsk, Russia

Abstract. Introduction. In recent decades, there has been a signifi cant increase in the number of metabolic syndrome cases, requiring special attention and the use of new methods for its diagnosis, prognosis and treatment monitoring. Aim. To analyze the association of triglyceride-glucose index and its modifi cations with the presence of metabolic syndrome in young adults. Materials and Methods. The case-control study involved 863 young people aged 18-44 years. Anthropometric and laboratory studies were conducted, including the calculation of insulin resistance indices and assessment of their association with metabolic syndrome. The logistic regression method was used in statistical processing. Results and Discussion. When analyzing the contribution of insulin resistance indices, the triglyceride-glucose index demonstrated the greatest association with the presence of metabolic syndrome: With an increase of 1 unit, the chances of detection increased by 12.06 times, which is 7.25 times more often than the HOMA-IR index and 3.75 times more often than the triglyceride-glucose index – waist circumference to height ratio. Conclusions. The triglyceride-glucose index is an important tool for assessing insulin resistance and its use, taking into account gender and ethnic diﬀ erences, allows achieving optimal results in the diagnosis and prevention of metabolic syndrome.

Keywords: metabolic syndrome, triglyceride-glucose index (TyG); triglyceride-glucose-body mass index (TyG-BMI); triglyceride-glucose index-waist circumference (TyG-WC); triglyceride-glucose-waist-height ratio (TyG-WHtR).

For citation: Korneeva, E.V.; Voevoda, M.I. Association of the triglyceride-glucose index and its modifi cations with metabolic syndrome in young people. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 35-40. DOI: 10.20969/VSKM.2025.18(2).35-40.

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УДК: 616.717.9-002.5 DOI: 10.20969/VSKM.2025.18(2).41-47

Dynamics of total lipid parameters related to constitutional syndrome in patients with HIV-associated tuberculosis

Pavel V. Makarov1, Irina E. Kravchenko2, Sergey V. Starikov1, Oleg V. Nozdrevatykh1, Elena V. Chaynikova1

1Tver State Medical University, 4 Sovetskaya str.,170100 Tver, Russia

2Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia

Abstract. Introduction. Lipid imbalance is an important pathogenetic element in the development of constitutional syndrome at late stages of HIV infection. Studying the dynamics of total lipid fractions is a prerequisite for expanding the diagnostic potential of and for a more detailed understanding the pathogenesis of this condition. Aim. To evaluate the dynamics of total lipid fractions in HIV/tuberculosis patients in stages 4A-B with decreased body weight, with and without antiretroviral therapy. Materials and Methods. Total lipid fractions were studied by one-dimensional flow chromatography in 100 patients with HIV-associated tuberculosis who received antituberculosis chemotherapy and in 100 patients with HIV/tuberculosis who received antiretroviral therapy on the background of antituberculosis therapy for 2 months. The control group consisted of 50 healthy individuals. All patients underwent the immunophenotyping of CD4-lymphocytes with determination of absolute and relative numbers of and HIV RNA viral load. The data were statistically analyzed using parametric statistical methods. Results and Discussion. The levels of free fatty acids and total cholesterol before treatment were higher and those of triglycerides lower in both groups of patients compared to the group of healthy individuals (p<0.001). After one month of antiretroviral therapy against the background of antituberculosis treatment in group 2, positive shifts were noted in the form of triglycerides increase and total cholesterol decrease to the level of healthy individuals (p<0.001), free fatty acids level decrease (p<0.05) against the values before treatment. Against the background of triglycerides level normalization with simultaneous reduction of free fatty acids, there was a signifi cant decrease in the number of patients with constitutional syndrome manifestations (from 66/66% down to 37/37%, p<0.001). In group 1 receiving antituberculosis therapy only, there were no such changes: The levels of triglycerides, total cholesterol and free fatty acids did not change signifi cantly compared to the beginning of therapy and to the control group (p>0.05). Conclusions. In the group of patients receiving antiretroviral and antituberculosis therapy, the disturbed ratio of total lipid fractions was restored. A relative decrease in the levels of free fatty acids and a simultaneous increase in triglyceride levels compared to the same of healthy individuals against the background of antiretroviral therapy contributed to the decrease in the number of patients with constitutional syndrome.

Keywords: HIV infection, tuberculosis, lipids, constitutional syndrome, antiretroviral therapy, triglycerides.

For citation: Makarov, P.V.; Kravchenko, I.E.; Starikov, S.V.; et al. Dynamics of total lipid parameters related to constitutional syndrome in patients with HIV-associated tuberculosis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 41-47. DOI: 10.20969/VSKM.2025.18(2).41-47.

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УДК 615.1:616-036.21-02:578.834.1 DOI: 10.20969/VSKM.2025.18(2) .48-54

A sociological study of the pharmaceutical care quality during the coronavirus pandemic

Leysan I. Motygullina1, Ruzaliya G. Tukhbatullina1

1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia

Abstract. Introduction. The study examines the pandemic experience from a sociological point of view through the opinions of many respondents. Aim. The aim of the study is to provide a sociological assessment of the availability and quality of pharmaceutical care during the coronavirus pandemic. Materials and Methods. A survey was conducted with 405 respondents from among non-medical and non-pharmaceutical population, 370 doctors, and 374 pharmacists. Correlation and regression analysis was used to process the results. Results and Discussion. The study showed that the majority of the population is partially satisfi ed with the range of medicines available for the COVID-19 treatment, half of the respondents surveyed have increased their level of trust in and respect for pharmaceutical personnel during the coronavirus pandemic. Pharmacists noted the high demand of the population for professional advice, while the quality of pharmaceutical care was assessed as satisfactory. The doctors gave a positive assessment of the quality and accessibility of pharmaceutical care provided by pharmacies to the population. Conclusions. There is a high need for improving the system of providing medicines, information support for all respondents, information exchange between medical and pharmaceutical specialists, as well as working towards strengthening the psycho-emotional state of pharmacists in critical situations.

Keywords: pharmaceutical care, coronavirus infection, questionnaire.

For citation: Motygullina, L.I.; Tukhbatullina, R.G. A sociological study of the pharmaceutical care quality during the coronavirus pandemic. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 48-54. DOI: 10.20969/VSKM.2025.18(2).48-54.

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УДК: 616.36+618.1+618.2 DOI: 10.20969/VSKM.2025.18( 2).55-60

Clinical-hormonal aspects of women of reproductive age with prolactinomas

Khurshidaxon К. Nasirova1, Nadira V. Khodjayeva1, Gulchehra D. Narimova2, Oguldzhan К. Saitmuratova1, Sanobar U. Samijonova1

1Pediatric Endocrinology of the Tashkent Pediatric Medical Institute, 223 Bogishamol street, 100140 Tashkent, Uzbekistan

2Republican Specialized Scientific and Practical Medical Center of Endocrinology named after Acad. Yo. Kh. Turakulov, 103 Mirzo Ulugbek str., Mirzo Ulugbek District, 100047 Tashkent, Uzbekistan

Abstract. Introduction. Prolactinoma is the most common pituitary adenoma, constituting 40-66% of cases in epidemiological studies. Its prevalence ranges from 25 to 63 per 100,000, with incidence rates of 2.1 to 5.4 cases per 100,000 annually. The increasing detection of prolactinomas is attributed to advances in imaging techniques, such as computer tomography / magnetic resonance tomography, and to the improved laboratory techniques, such as Enzyme Linked Immunosorbent Assay or Immunoradiometric assay, enabling earlier diagnosis. Regardless of tumor size, reproductive dysfunction—ranging from reduced libido through infertility — is a common symptom of the condition. The aim of this study is to evaluate the clinical-hormonal profi le of women of reproductive age with prolactinomas and to analyze the relationship between prolactin levels, clinical manifestations of the disease, and reproductive function disorders. Material and Methods. The study involved 185 women aged 17 to 37 with prolactinomas, divided into two groups based on tumor size: Microadenomas and macroadenoma s. The methods included cli nical (BMI, blood calcium, vitamin D3, general blood test), hormonal (Prolactin, Follicle-Stimulating Hormone, Luteinizing Hormone, progesterone, estradiol, testosterone, Thyroid-Stimulating Hormone, free T4, inhibin A/B, activin, anti-Mullerian hormone), instrumental (ultrasound with folliculometry), and neuroimaging (neuro-ophthalmological, computer tomography / magnetic resonance tomography) techniques, alongside with statistical analysis. Results and Discussion. The study of 185 women with prolactinomas revealed that 61.6% were diagnosed during pregnancy, with microadenomas being more common. Patients experienced reproductive issues, including infertility and menstrual irregularities, alongside with hormonal imbalances, such as elevated prolactin and reduced Follicle-Stimulating Hormone and Luteinizing Hormone. Early detection and tailored treatment are crucial for managing these complications. Conclusions. Prolactinomas in women of reproductive age are associated with signifi cant reproductive and hormonal disturbances. Early diagnosis and personalized treatment are essential to manage symptoms, including infertility and menstrual irregularities, and to improve patients’ outcomes.

Keywords: clinical-hormonal profi le, women, reproductive age, prolactinoma.

For citation: Nasirova, K.К.; Khodjayeva, N.V.; Narimova, G.D.; et al. Clinical-hormonal aspects of women of reproductive age with prolactinomas. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 55-60. DOI: 10.20969/VSKM.2025.18(2).55-60.

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УДК: 616.915-053.8 DOI: 10.2096 9/VSKM.2025.18(2) .61-67

Measles in adults at the present stage

Irina V. Nikolaeva1, Alfia I. Fazulzyanova1, Svetlana V. Tkacheva1, Olga A. Rakhmanova2, Tatyana M. Martynova2, Olga V. Zhemkova2, Ramzilya R. Aleeva1, Aliya Z. Gilmullina1

1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia

2Republican Clinical Infectious Diseases Hospital named after Professor A. F. Agafonov, 83 Pobedy Ave., 420110 Kazan, Russia

Abstract. Introduction. Measles is an acute, highly contagious viral disease with an aerosol mechanism of transmission that can lead to serious complications and death. The incidence of measles increased 147-fold in the Republic of Tatarstan in 2023. Aim. The aim of the study was to analyze the clinical, epidemiological and laboratory features of measles in adults during the period of increased incidence. Materials and Methods. The clinical, epidemiological, laboratory and instrumental data were analyzed for 185 adult patients hospitalized with a diagnosis of measles at the Republican Clinical Infectious Diseases Hospital from February 2023 to June 2024. Descriptive statistics methods were used for statistical analysis. Qualitative indicators are presented in the form of absolute and relative values, the arithmetic mean and standard deviation were calculated for quantitative data with a normal distribution. Results and Discussion. The majority of those hospitalized were working patients aged 21 to 40 (63.2%) living in Kazan (74.1%). Measles occurred in a typical moderate form (98.9%) with a high incidence of pneumonia (44.3%) and a favorable outcome in 100% of cases. Full measles vaccination according to the preventive vaccination calendar was carried out in 77 (41.6%) of the patients studied. Only 73 (39.5%) patients were referred to the hospital with the diagnosis of measles. The clinical diagnosis was confi rmed by the detection of measles IgM antibodies using enzyme-linked immunosorbent assay (100%), as well as the detection of measles virus RNA by reverse transcription PCR in oropharyngeal smears. An increase in C-reactive protein (92.1%) may be associated with virus-induced or bacterial infl ammation. Hyperfermentemia is a common occurrence in measles patients and has a favorable prognosis. Conclusions. The susceptibility of twice-vaccinated patients to measles justifi es the need for serological monitoring of antibodies to measles virus in adults with further revaccination. PCR is the most eﬀ ective method of early laboratory diagnosis allowing the detection of viral RNA during the catarrhal period of the disease. The problems of diagnosing measles in adults, which arise at the outpatient stage of medical care, dictate the need to raise awareness and alertness of doctors to this infection.

Keywords: measles, morbidity, clinic, diagnosis.

For citation: Nikolaeva, I.V.; Fazulzyanova, A.I.; Tkacheva, S.V.; et al. A.Z. Measles in adults at the present stage. The Bulletin of Contemporary Cli nical Medicine. 2025, 18 (2), 61-67. DOI: 10.20969/VSKM.2025.18(2).61-67.

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УДК: 616–06:616-072.1-71 DOI: 10.20969/VSKM.2025.18(2).68-74

Endoscopic features of respiratory tract lesions in chronic obstructive pulmonary disease, pulmonary tuberculosis and HIV infection: a comparative analysis

Hadi Tlais1, Svetlana P. Shchelykalina1, Eldar Kh. Anaev1

1N. I. Pirogov Russian National Research Medical University, 1 Ostrovityanova str., 117997 Moscow, Russia

Abstract. Introduction. Chronic obstructive pulmonary disease (COPD) characterized by chronic, persistent, and irreversible airfl ow limitation, represents a signifi cant global health challenge. Chronic respiratory symptoms, structural lung changes detected via imaging, and decreased lung function are observed in 30–50% of patients with tuberculosis. This disease remains a leading cause of mortality among HIV-infected individuals. In clinical practice, bronchoscopy is widely used as a diagnostic tool and for identifying pulmonary pathogens in patients with respiratory diseases. Cellular patterns in bronchoalveolar lavage (BAL) refl ect immune processes and the condition of the airways. Aim. To conduct a comparative analysis of the endoscopic fi ndings and bronchoalveolar lavage results in patients with COPD and pulmonary tuberculosis, both HIV-infected and non-infected. Materials and Methods. The study included 160 patients with COPD and pulmonary tuberculosis, of whom 80 were HIV-positive, and 80 were HIV-negative. Patients were hospitalized at the State Institution “City Tuberculosis Dispensary” (St. Petersburg). Bronchoscopy with BAL sampling for cytology was performed, along with an assessment of the severity of endobronchitis and bronchial scarring. Results and Discussion. Among the analyzed indicators, neutropenia in BAL was observed more frequently in HIV-positive patients compared to HIV-negative ones: 79 [59.5; 89.78]% versus 85.5 [68.75; 92.28]% (p=0.038), respectively. No significant diﬀerences were found between the groups in terms of eosinophil, lymphocyte, and macrophage counts (p>0.05). HIV-positive patients with COPD and tuberculosis had more severe endobronchitis compared to HIV-negative patients: grade II was detected in 53 patients (66% (95% CI 55–76%)) versus 37 patients (46% (95% CI 36–57%)) (p=0.001). HIV-positive patients exhibited less frequent scarring compared to HIV-negative patients: 43 patients (54% (95% CI 42–65%)) versus 28 patients (35% (95% CI 25–47%)) (p=0.026). Additionally, among HIV-positive patients with low viral loads receiving antiretroviral therapy (ART), scarring was less common compared to those with high viral loads not receiving ART: 24 (67% (95% CI 49–81%)) versus 19 (43% (95% CI 29–59%)) (p=0.044). Conclusions. HIV-infected patients with COPD and tuberculosis exhibit reduced neutrophil counts in BAL, more pronounced bronchial scarr ing, and more severe endobronchitis on bronchoscopy compared to HIV-negative patients.

Keywords: chronic obstructive pulmonary disease, COPD, pulmonary tuberculosis, HIV infection, bronchoscopy, bronchoalveolar lavage, endobronchitis, cicatricial changes.

For citation: Tlais, H.; Shchelykalina, S.P.; Anaev, E.Kh. Endoscopic features of respiratory tract lesions in chronic obstructive pulmonary disease, pulmonary tuberculosis and HIV infection: a comparative analysis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 68-74. DOI: 10.20969/VSKM.2025.18(2).68-74.

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УДК: 616.831-002:578.834-06 DOI: 10.20969/VSKM.2025.18(2) .75-81

Prediction of maxillofacial complications in post-COVID-19 patients, using magnetic resonance imaging

Adkham I. Khasanov1, Elmira B. Baykhodjaeva1, Mirshod J. Atavullaev2, Lalita R. Yunusova1

1Tashkent State Dental Institute, 103 Maxtumkuli str., Yashnabad District, 100047 Tashkent, Uzbekistan

2Bukhara State Medical Institute named after Abu Ali ibn Sino, 23 Gijduvanskaya str., 200118 Bukhara, Uzbekistan

Abstract. Introduction. The COVID-19 pandemic has had a signifi cant impact on patients’ health, leading to the development of some long-term complications, including pathologies in the maxillofacial region. Magnetic resonance

imaging (MRI), as a highly eﬀ ective imaging method, allows for the early detection of these changes, facilitating timely intervention and reducing the risk of further complications. Early prediction and diagnosis of such conditions are critical for optimizing treatment approaches and improving the post-COVID-19 patients’ quality of life. The aim of this study is to analyze the use of magnetic resonance imaging for predicting maxillofacial complications in patients who have recovered from COVID-19, with the goal of improving early diagnosis of and appropriate treatment of these complications. Materials and Methods. The study included 41 patients with the early MRI signs of post-COVID complications in the midface (average age 45 ± 5 years, 73% being male patients) and 48 patients with late complications (average age 45 ± 3 years, 56.3%being male patients). MRI was performed on a 1.5 Tesla scanner using standard coils for the head and neck. The protocol included axial T1WI, T2WI, T2GRE, FLAIR, and DWI images, as well as contrast-enhanced magnetic resonance angiography to assess vascular changes and pathologies. Results and Discussion. During the study, MRI examinations were performed on patients who had recovered from COVID-19 to identify pathologies in their maxillofacial regions. The following typical complications were found: Osteonecrosis of the maxilla, infl ammatory processes in the facial soft tissues, and changes in blood supply. Prediction of possible complications based on MRI data allowed for early diagnosis and prevention of the development of severe conditions in many patients. Conclusions. The use of magnetic resonance imaging is an eﬀ ective tool for predicting complications in the maxillofacial region in patients who have recovered from COVID-19. Timely diagnosis can prevent further deterioration of the condition and contributes to a more accurate selection of treatment strategies. The inclusion of MRI in the comprehensive examination of post-COVID-19 patients will improve diagnostic accuracy and improve the disease prognosis.

Keywords: MRI, early signs, prognosis, maxillofacial region, complications, COVID-19.

For citation: Khasanov, A.I.; Baykhodjaeva , E.B.; Atavullaev, M.J.; Yunusova, L.R. Prediction of maxillofacial complications in post-COVID-19 patients, using magnetic resonance imaging. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 75-81. DOI: 10.20969/VSKM.2025.18(2).75-81.

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1. Исраилова М.Н., Юнусова Л.Р., Ходжибекова Ю.М., Юлдашева Д.Ю. Роль МСКТ и МРТ в дифференциальной диагностике осложнений средней зоны лица у пациентов с патологией грибковой этиологии // Вестник современной клинической медицины. – 2023. – Т.16, Прил. 2. – С.24-28. [Israilova MN, Yunusova LR, Khodjibekova YM, Yuldasheva DY. Rol MSKT i MRT v differentsialnoy diagnostike oslojneniy sredney zoni litsa u patsientov s patologiey gribkovoy etiologii [The role of MSCT and MRI in the diﬀ erential diagnosis of complications in the midface in patients with fungal etiology]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine]. 2023; 16 (suppl 2): 24-28. DOI: 10.20969/VSKM.2023.16(suppl.2).24-28

2. Исмаилова М.Х., Юнусова Л.Р., Хайдарова Г.Б., Абдуллаева Л.Ш. Мультимодальная визуализация осложнений челюстно-лицевой области у пациентов с сахарным диабетом, перенесших Covid-19 // Вестник современной клинической медицины. – 2023. – Т.16, Прил. 2. – С.19-23. [Ismailova MH, Yunusova LR, Khaydarova GB, Abdullaeva LS. Multimodalnaya vizualizatsiya oslojneniy chelyustno-litsevoy oblasti u patsientov s saxarnim diabetom, perenesshix Covid-19 [Multimodal imaging of complications in the maxillofacial area in patients with diabetes mellitus who have undergone COVID-19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine]. 2023; 16 (suppl 2): 19-23. DOI: 10.20969/VSKM.2023.16(suppl.2).19-23

3. Юнусова Л.Р., Икрамов Г.О., Халманов Б.А., Сувонов К.Ж. МСКТ диагностика остеомиелита верхней челюсти, у пациентов перенесших COVID-19 // Вестник современной клинической медицины. – 2022. – Т.15, вып.5. – С.81-85. [Yunusova LR, Ikramov GO, Halmanov BA, Suvanov KJ. MSKT diagnostika osteomielita verhnej chelyusti, u pacientov perenesshih COVID-19 [MSCT diagnosis of osteomyelitis of the upper jaw, in patients who underwent COVID-19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine.] 2022; 15 (5): 81-85. DOI: 10.20969/VSKM.2022.15(5).81-85

4. Ходжибекова Ю.М., Юнусова Л.Р., Амонуллоев Р.А., Икрамов Г.А. МРТ визуализация осложнений средней зоны лица у пациентов, перенесших COVID-19. Вестник современной клинической медицины. – 2023. – Т.16, Прил.2. – С.49-54. [Khodjibekova YM, Yunusova LR, Amonulloev RA, Ikramov GA. MRT vizualizatsiya oslojneniy sredney zonы litsa u patsientov, perenesshix COVID-19. Vestnik sovremennoy klinicheskoy meditsiny [MRI visualization of midface complications in patients who underwent COVID-19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine.] 2023; 16 (suppl 2): 49-54. DOI: 10.20969/VSKM.2023.16(suppl.2).49-54

5. Yunusova LR, Khodjibekova YuM, et al. Visualization of complications of the middle zone of the person who underwent Covid-19. Pediatrics scientific and practical journal. 2021; 6: 25-31. DOI: 10.37988/1811-153X_2022_2_94

6. Bannikov SA, Mironov GV, Boyko NV. Fungal lesion of the paranasal sinuses. Etiology, pathogenesis, classifi cation. Experimental and clinical otorhinolaryngology. 2020; 1 (02): 32–35.

7. John TM, Jacob CN, Kontoyiannis DP. When uncontrolled diabetes mellitus and severe COVID-19 converge: the perfect storm for mucormycosis. J Fungi (Basel). 2021; 7 (4): 298. DOI: 10.3390/jof7040298

8. Wenlong Li, Zeqing Huang, Biao Tan, et all. General recommendation for assessment and management on the risk of glucocorticoid-induced osteonecrosis in patients with COVID-19. J Orthop Translat. 2021; 31: 1–9. DOI: 10.1016/j.joms.2021.09.009

9. Singh AK, Singh R, Joshi SR, Misra A. Mucormycosis in COVID-19: a systematic review of cases reported worldwide and in India. Diabetes Metab Syndr. 2021; 15 (4): 102-146. DOI: 10.1016/j.dsx.2021.05.019

10. Al-Tawfi q JA, Alhumaid S, Alshukairi AN, et al. COVID-19 and mucormycosis superinfection: the perfect storm. Infection. 2021; 49 (5): 833–853. DOI: 10.1007/s15010-021-01670-1

УДК: 616.831-005.4-08:616.831-005.1-084 DOI: 10.20969/ VSKM.2025.18(2).82-90

Transient ischemic attacks and differentiated approaches to patient management for stroke prevention

Dilbar N. Hidoyatova1, Muborak B. Abdullaeva1, Malika M. Raimova1, Muzayyam O. Tursunova1, Rano M. Abduzhamilova2

1Tashkent State Dental Institute, 103 Mahtumkuli str., 100047 Tashkent, Uzbekistan

2Center for the Development of Professional Qualification of Medical Workers, 51 Parkent str., 100007 Tashkent, Uzbekistan

Abstract. Introduction. According to WHO, stroke is the leading cause of disability in adults. The concept of cerebral circulatory disorders includes both stroke and transient cerebral circulatory disorders and transient ischemic attacks, and these are precursors to stroke. To assess the risk of its development, a clinical scale is used which includes items, such as age, blood pressure, clinical symptoms, duration of symptoms, and the presence of diabetes mellitus. The aim of this study is to develop a diﬀ erentiated approach to secondary stroke prevention in patients with transient ischemic attacks. Material and Methods. This study involved 238 patients aged 31 to 86 years, treated for transient ischemic attacks in the clinic of the Centre for Emergency Medical Care within the period from 2011 to 2022. During our research, we used general clinical and special research methods, such as neurological examination, Glasco coma scale, National Institute of Health Stroke Scale, Modifi ed Rankin scale, multispiral computed tomography, multispiral computed tomographic angiography, magnetic resonance tomography, and transcranial Doppler sonography. Results and Discussion. Five pathogenetic subtypes of transient ischemic attacks (atherothrombotic, cardioembolic, hemodynamic, lacunar, and hemorheological micro-occlusion) were revealed, the distribution of which depended on the treatment type: All subtypes in conservative therapy, only atherothrombotic and hemodynamic subtypes in classical carotid endarterectomy, and exclusively atherothrombotic subtype in stenting. Worsening of atherosclerotic lesion of carotid arteries was accompanied by a decrease in cognitive functions (Brief Mental Status Evaluation Scale: 25 to 22.5 points) and increase in neurological defi cit (National Institutes of Health Stroke Scale: 7.1 to 8.6 points) and in the duration of transient ischemic attacks (144 to 344 min). Left ventricular hypertrophy and diabetes mellitus worsened the course of transient ischemic attacks, increasing cognitive and motor impairment, as well as the risk of stroke (clinical scale is used to assess the risk of early stroke after a transient ischemic attack: 4.7 and 5.1 points versus 3.8 and 4.3 points, p<0.01). Conclusions. Transient ischemic attacks, closely linked to ischemic stroke, progress based on the extent of carotid artery damage and risk factors like left ventricular hypertrophy and diabetes, which lead to worsening cognitive and neurological defi cits and to increasing stroke risk in patients with advanced atherosclerosis and comorbidities.

Keywords: transient ischemic attack, ischemic stroke, clinical scale is used to assess the risk of early stroke after a transient ischemic attack, carotid endarterectomy, occlusion.

For citation: Khidoyatova, D.N.; Abdullaeva, M.B.; Raimova, M.M.; et al . Transient ischemic attacks and diﬀ erentiated approaches to patient management for stroke prevention. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 82-90. DOI: 10.20969/VSKM.2025.18(2).82-90.

REFERENCES

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6. Coutts SB, Demchuk AM, Dowlatshahi D. Diffusion-Weighted Imaging in Transient Ischemic Attack: A Review. International Journal of Stroke. 2007; 2(4):193–203. DOI: 10.1111/j.1747-4949.2007.00190.x

7. Meschia JF, Kittner SJ, Schwamm LH, et al. Management of Transient Ischemic Attack: A Call for Early and Aggressive Intervention. Stroke. 2005; 36(2):431–435. DOI: 10.1161/01.STR.0000158482.15243.27

8. Amarenco P, Bogousslavsky J, Callahan A, et al. High-Dose Atorvastatin after Stroke or Transient Ischemic Attack. New England Journal of Medicine. 2006; 355(6):549–559. DOI: 10.1056/NEJMoa061626

9. Johnston SC, Rothwell PM, Nguyen-Huynh MN, et al. Short-Term Prognosis after Emergency Department Diagnosis of Transient Ischemic Attack. New England Journal of Medicine. 2007; 357(21):2098–2107. DOI: 10.1056/NEJMoa067205.

10. Sacco RL, Adams RJ, Albers GW, et al. Transient Ischemic Attack. JAMA. 2012; 307(21):2282–2288. DOI: 10.1001/jama.2012.360

11. Sheehan OC, et al. An Updated Review of TransientIschemic Attack and Stroke Prevention. Lancet Neurology. 2009; 8(4):384–393. DOI: 10.1016/S1474-4422(09)70048-3

12. Makin SD, et al. Acute Management and Secondary Prevention of Transient Ischemic Attack and Minor Stroke. BMJ. 2015; 351:h3432. DOI: 10.1136/bmj.h3432

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14. Albers GW, et al. The Role of Imaging in Transient Ischemic Attack. In: Handbook of Clinical Neurology. 2017; 140:229–242. DOI: 10.1016/B978-0-444-63600-3.00015-4

УДК: 616.716.1-002.77-073.75:616-006.04 DOI: 10.20969/VSKM.2025.18(2).91-95

Value of computed tomography and magnetic resonance imaging in the differential diagnosis of midface complications in fungal pathologies

Yulduz M. Khodjibekova1, Marat X. Khodjibekov2, Adkham I. Khasanov1, Zafar B. Abdashimov1, Lalita R. Yunusova1

1Tashkent State Dental Institute, 103 Maxtumkuli Street, Yashnabad District, 100047 Tashkent, Uzbekistan

2Tashkent Medical Academy, Uzbekistan, 100109, Tashkent, Almazar district, Farobi street, 2

Abstract. Introduction. Midface lesions caused by fungal infections are one of the most challenging tasks in modern clinical practice in terms of diagnosis and treatment. In recent years, against the backdrop of increasing cases of invasive fungal diseases, such as mucormycosis, the importance of accurate and timely diagnosis has increased signifi cantly. These infections, often developing in immunocompromised patients, aﬀ ect both soft tissues and bone structures, making diagnosis particularly important. The aim of the study was to determine the diagnostic value of computed tomography and magnetic resonance imaging methods in the detection and diﬀ erential diagnosis of midface complications caused by fungal infections, considering their spread to soft tissues and bone structures. Materials and Methods. During a two-year observation period, 40 cases of fungal sinusitis were diagnosed clinically. Among the patients, there were 22 men (55%) and 18 women (45%), aged 47 ± 2 years on average. Standard CT protocols were used for diagnosing with the slice thickness of 1.25 mm, including axial and coronal slices with contrast enhancement. Assessment of disease dynamics was based on changes in the volume of infl ammatory processes, bone structure, and surrounding tissues. Magnetic resonance imaging diagnostics were performed on a 1.5 Tesla scanner using standard coils for head and neck. The protocol included axial T1WI, T2WI, T2GRE, FLAIR, and DWI images, as well as contrast-enhanced magnetic resonance angiography to assess vascular changes and pathologies. Results and Discussion. The study analyzed 40 cases of fungal sinusitis confi rmed by computed tomography, magnetic resonance imaging, and histological examination. Clinical manifestations, the nature of paranasal sinus involvement, radiological signs, and the frequency of complications were evaluated. The most common pathogens identifi ed were Aspergillus spp. and Penicillium spp., predominantly aﬀ ecting the maxillary sinus. On computed tomography and magnetic resonance imaging methods, thickening of the mucous membrane, bone destruction, and changes in tissue density were observed. Complications, including osteomyelitis and abscesses, required diﬀ erential diagnosis with malignant tumors. Conclusions. Computed tomography and magnetic resonance imaging are important diagnostic methods for fungal sinusitis, allowing the identifi cation of changes in sinus structures, bones, and soft tissues, as well as the assessment of the infection spread, which helps prevent complications and improve treatment outcomes.

Keywords: fungal complications, maxilla, computed tomography, magnetic resonance imaging, COVID-19.

For citation: Khodjibekova, Yu.M.; Khodjibekov, M.X.; Khasanov, A.I.; et al. Value of computed tomography and magnetic resonance imaging in the diﬀ erential diagnosis of midface complications in fungal pathologies. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 91-95. DOI: 10.20969/VSKM.2025.18(2).91-95.

REFERENCES

2. Исмаилова М.Х., Юнусова Л.Р., Хайдарова Г.Б., Абдуллаева Л.Ш. Мультимодальная визуализация осложнений челюстно-лицевой области у пациентов с сахарным диабетом, перенесших Covid-19 // Вестник современной клинической медицины. – 2023. – Т.16, Прил. 2. - С.19-23. [Ismailova MH, Yunusova LR, Khaydarova GB, Abdullaeva LS. Multimodalnaya vizualizatsiya oslojneniy chelyustno-litsevoy oblasti u patsientov s saxarnim diabetom, perenesshix Covid-19 [Multimodal imaging of complications in the maxillofacial area in patients with diabetes mellitus who have undergone COVID-19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine]. 2023; 16 (suppl 2): 19-23. DOI: 10.20969/VSKM.2023.16(suppl.2).19-23

4. Ходжибекова Ю.М., Юнусова Л.Р., Амонуллоев Р.А., Икрамов Г.А. МРТ визуализация осложнений средней зоны лица у пациентов, перенесших COVID-19 // Вестник современной клинической медицины. – 2023. – Т.16, Прил.2. – С.49-54. [Khodjibekova YM, Yunusova LR, Amonulloev RA, Ikramov GA. MRT vizualizatsiya oslojneniy sredney zonы litsa u patsientov, perenesshix COVID-19 [MRI visualization of midface complications in patients who underwent COVID-19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine.] 2023; 16 (suppl 2): 49-54. DOI: 10.20969/VSKM.2023.16(suppl.2).49-54

6. McHugh JD, et al. Invasive fungal sinusitis: a review of 115 cases. Journal of Clinical Microbiology. 2016; 54 (2): 479-484.

7. Ravindra KS, et al. Histopathologic features of fungal infections in the paranasal sinuses. American Journal of Rhinology & Allergy. 2018; 32 (5): 412-418.

8. Bergin CJ, et al. CT and MRI fi ndings in invasive fungal rhinosinusitis: a diagnostic review. European Radiology. 2019; 29(7): 3676-3683.

9. He X, et al. CT imaging characteristics of invasive fungal sinusitis. European Journal of Radiolog. 2021; 136: 109554.

10. Johnson AR, et al. The role of Aspergillus species in invasive fungal sinusitis. Journal of Fungal Infections. 2017; 30 (2): 112-118.

11. Aronson J, et al. Non-Aspergillus fungal infections in theparanasal sinuses: diagnostic and therapeutic challenges. Medical Mycology. 2020; 58 (7): 806-812.

12. Mullen P, et al. Role of CT and MRI in the management of fungal rhinosinusitis. Diagnostic Imaging. 2018; 68 (4): 40-47.

13. Song WJ, et al. CT and MRI features of chronic rhinosinusitis with fungal elements. Imaging Medicine. 2015; 7 (6): 63-70.

УДК: 616.211-002.3-053.2 DOI: 10.20969/VSKM.2025.18(2).96-101

Features of mucociliary transport in chronic rhinosinusitis in children of the Aral Sea Region: Endoscopy and computed tomography findings

Sarsenbay N. Usenov1

1Munaila District Hospital, 24/1 Mangistau Village, 130006 Munaila District, Mangistau Region, Kazakhstan

Abstracts. Introduction. The relevance of the study is determined by a signifi cant increase in the incidence of chronic rhinosinusitis in children in the Aral Sea Region, which is associated with unfavorable environmental factors and changes in immunoreactivity predisposing to the chronicity of infl ammatory process. The assessment of clinical features, as well as the study of pathogenetic mechanisms and the state of the immune system in children living in an environmentally unfavorable zone, are of key importance for the improvement of the diagnostic methods and therapy of these diseases. The aim of this study is to analyze the characteristics of mucociliary transport revealed by endoscopic examination and computed tomography in children with chronic rhinosinusitis living in the Aral Sea Region. Materials and Methods. The study covered 137 children with chronic rhinosinusitis treated from 2018 to 2020 in diﬀ erent medical center of Uzbekistan. Endoscopy, computer tomography, and radiography, as well as nasal mucosa fl uorescence test, were used for diagnosing. The analysis data were entered into tables and processed using statistical methods including the paired Student’s criterion. Results and Discussion. The study showed a signifi cant inhibition of transport function of the mesenteric epithelium in children living in the ecologically unfavorable zone of the Aral Sea Region, which is manifested in the increase of saccharine test time up to 29.4±0.9 minutes in the main group. Endoscopic examination of the nasal cavity revealed pronounced hypertrophic and sub-atrophic changes in the mucosa, with predominance of sub-atrophy in 60.3% of children from the main group, which indicates a disorder in the functional activity of the mucosa and a decrease in its protective properties. In the group with chronic rhinosinusitis and nasal polyps, structural changes were found, including mucosal thickening and the presence of dry crusts, which confi rms prolonged infl ammation and disturbances in the aeration of nasal cavities. Conclusions. In children of the Aral Sea Region, chronic rhinosinusitis is characterized by a similar degree of severity of clinical symptoms for polypous and polyposis-free forms, with deterioration of the quality of life (less than 50 SF-36 scores). There is also a dissociation between clinical symptoms and scanty computer tomography picture, with the same distribution of pathological changes in the paranasal sinuses according to the Lund-Mackay scale (11.2±0.34 points).

Keywords: chronic rhinosinusitis, Aral Sea Region, endoscopy, computer tomography scans

For citation: Usenov, S.N. Features of mucociliary transport in chronic rhinosinusitis in children of the Aral Sea Region: Endoscopy and computed tomography fi ndings. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 96-101. DOI: 10.20969/VSKM.2025.18(2).96-101.

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13. Zhao Y, Li C, Wang W, et al. Mucociliary transport and epithelial remodeling in chronic rhinosinusitis. American Journal of Rhinology & Allergy. 2016; 30 (2): 131–138.

14. Ramadan HH. Imaging for pediatric chronic rhinosinusitis: a systematic review. Otolaryngology–Head and Neck Surgery. 2017; 157 (1): 28–32.

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REVIEWS

УДК: 7696.332-796.422.12 DOI: 10.2 0969 /VSKM.2025.18(2).102-109

International clinical guidelines and research findings on the potential of multiparametric magnetic resonance imaging in diagnosing hepatocellular carcinoma: A comprehensive review

Sherzod B. Juraev1, Yulduz M. Khodjibekova1, Marat X. Khodjibekov2, Zafar B. Abdashimov1

1Tashkent State Dental Institute, 103 Maxtumkuli str., Yashnabad District, 100047 Tashkent, Uzbekistan

2Tashkent Medical Academy, 2 Farobi str., Almazar District, 100109 Tashkent, Uzbekistan

Abstract. Introduction. Hepatocellular carcinoma is one of the most common and the deadliest cancers worldwide, especially in high incidence regions, such as Asia and Africa. With increasing incidence and signifi cant geographical variation, it is crucial to develop and improve non-invasive diagnostic techniques, such as multiparametric magnetic resonance imaging allowing treatment to be initiated without prior biopsy. Aim of the study was to analyze international clinical guidelines and data from clinical studies on the diagnosis of hepatocellular cancer, to demonstrate the capabilities of multiparametric magnetic resonance imaging with a liver-specifi c contrast agent, and to evaluate the diagnostic advantages of the technique compared to ultrasound, computed tomography, and magnetic resonance imaging with extracellular contrast agents. Material and Methods. We searched scientifi c publications and clinical gu idelines in PubMed and search.ebscohost.com information-analytical systems for the years 2020-2024, using the keywords, such as hepatocellular cancer, multiparametric magnetic resonance imaging of the liver, and gadoxetic acid. Abstracts were selected of 198 articles in PubMed and 19 articles at search.ebscohost.com. After excluding studies dealing with technical aspects and describing individual clinical observations and upon having analyzed the full texts of the articles, 50 publications were selected. Results and Discussion. The presented review demonstrated diagnostic advantages of multiparametric magnetic resonance imaging with liver-specifi c contrast agent, as well as a wide range of its applications at all treatment stages of a patient with hepatocellular cancer. In diﬃ cult diagnostic situations, in case of small tumor size and in cases where the diagnosis of hepatocellular cancer associated with liver cirrhosis is diﬃ cult due to structural and functional changes, it is advisable to perform magnetic resonance imaging. Application of diﬀ usion-weighted imaging and contrast enhancement, including hepatotropic contrast agents, allows increasing the sensitivity and specifi city of hepatocellular cancer diagnostics. Conclusions. Despite the existing variety of methods for diagnosing hepatocellular cancer, the advanced trend at present is multiparametric magnetic resonance imaging with a liver-specifi c contrast agent.

Keywords: hepatocellular cancer, multiparametric MRI, gadoxetic acid.

For citation: Juraev, Sh.B.; Khodjibekova, Yu.M.; Khodjibekov, M.X.; Abdashimov, Z.B. International clinical guidelines and research fi ndings on the potential of multiparam etric magnetic resonance imaging in diagnosing hepatocellular carcinoma: A comprehensive review. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 102-109. DOI: 10.20969/VSKM.2025.18(2).102-109.

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УДК 617.51-089.28. DOI: 10.20969/VSKM.2025.18(2).110-115

Surgical approaches to correcting posttraumatic nasal deformities

Nodir A. Ibadov1

1Tashkent State Dental Institute, Uzbekistan, Tashkent, 100047, Makhtumkuli str. 103

Abstract. Introduction. Posttraumatic nasal deformities represent a considerable challenge for otorhinolaryngologists and maxillofacial surgeons alike. This particular type of pathology frequently arises from traumatic injuries, leading to substantial morphological and functional impairments. The impact of these deformities extends beyond respiratory function, encompassing the aesthetic aspect of the nose, thus signifi cantly aﬀ ecting the aﬀ ected patient’s quality of life. The present study aims to analyze contemporary approaches to the surgical correction of posttraumatic nasal deformities, based on the actual literature. Materials and Methods. A comprehensive search was conducted on the databases, such as PubMed, Scopus, and Web of Science, using the following keywords: posttraumatic nasal deformity, rhinoplasty, surgical correction, and nasal trauma. The search was limited to articles published in the last decade to ensure the currency of the data. A total of 120 publications were reviewed, of which 45 that met the relevance criteria were selected for our further review. The study protocol was approved by the local ethical committee of the center An informed consent in wirting was obtained from each participant involved in the study. Results and Discussion. The results obtained from the analysis of scientifi c publications indicate that the advanced surgical approach to correcting post-traumatic nasal deformities encompasses a wide range of methods, including reconstructive rhinoplasty, the use of tissue grafts, and endoscopic techniques. The most eﬀ ective approaches are individualized, taking into account both aesthetic and functional needs of the patient. In recent years, signifi cant attention has been given to minimizing the invasiveness of surgeries and improving post-operative outcomes using advanced technologies, such as 3D modeling and laser techniques. An important aspect is also maintaining a balance between restoring normal respiratory function and the aesthetic appearance of the nose. Conclusions. Posttraumatic rhinoplasty is a complex procedure that can be eﬀ ective in restoring the shape an d function of the nose. Some factors contribute to the procedure eﬃ cacy, including an individualized approach, accurate diagnosis, and the use of advanced technologies. The procedure objective is twofold: First, achieving aesthetic goals and second, achieving functional goals. The latter is of particular importance as it improves the patients’ quality of life.

Keywords: posttraumatic nasal deformity, rhinoplasty, surgical correction, nasal trauma.

For citation: Ibadov, N.A. Surgical approaches to correcting posttraumatic nasal deformities. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 110-115. DOI: 10.20969/VSKM.2025.18(2).110-115.

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Features of COVID-19 progression in patients with metabolic syndrome: A literature review

Umida Z. Mirzaeva1, Khurshidakhon K. Nasirova1, Nodira V. Khodjaeva1, Gulchehra D. Narimova2

1Tashkent Pediatric Medical Institute, 223 Bogishamol str., 100140 Tashkent, Uzbekistan

2Republican Specialized Scientific and Practical Medical Center of Endocrinology named after Acad. Yo. Kh. Turakulov, 103 Mirzo Ulugbek str., 100047 Tashkent, Uzbekistan

Abstract. Introduction. Metabolic syndrome is a complex of clinical and biochemical disorders that increase the risk of atherosclerosis and cardiovascular diseases. It includes abdominal obesity, insulin resistance, carbohydrate metabolism disorders, arterial hypertension, and dyslipidemia, and it may also be associated with polycystic ovary syndrome and non-alcoholic fatty liver disease. The prevalence of metabolic syndrome continues to increase worldwide. Over the past three years, the COVID-19 pandemic has created a unique environment for the interaction of two global problems: Metabolic syndrome and COVID-19. This combination has led to new threats to public health and challenged the sustainability of the world’s health systems. The aim of the study was to investigate the impact of metabolic syndrome and COVID-19 on the health of the population and health care system in order to develop eﬀ ective prevention and treatment strategies. Material and Methods. Scientifi c publications were searched for in databases, such as Web of Science, PubMed, and RSNA, using the following keywords: metabolic syndrome, obesity, hyperglycemia, COVID-19. As a result, 150 articles were identifi ed. After removing duplicates (25 articles) and excluding publications with insuﬃ cient data (85 articles), 40 relevant articles were selected for further analysis. Results and Discussion. The study results showed that metabolic syndrome signifi cantly increases the risk of developing severe COVID-19 and the likelihood of hospitalization and mortality. Patients with metabolic syndrome, including obesity, arterial hypertension, and dyslipidemia, are more susceptible to infections, such as COVID-19, due to chronic infl ammation, insulin resistance, and endothelial dysfunction. At the same time, the COVID-19 pandemic exacerbated the course of metabolic syndrome, which is associated with impaired nutrition, lack of physical activity, and stressors. These data emphasize the need for a comprehensive approach to the prevention and treatment of both metabolic syndrome and COVID-19, with a focus on managing risk factors and improving the overall health of the population. Conclusions. Studies show that the combination of metabolic syndrome and COVID-19 signifi cantly worsens the health status of patients, increasing the risk of severe complications and worsening their clinical prognoses. The presence of metabolic syndrome is associated with increased vulnerability to a more severe course of COVID-19 and an increased likelihood of mortality. At the same time, the pandemic has contributed to worsening the risk factors for metabolic syndrome, such as obesity and hypertension, whi ch calls for mainstreaming approaches to the prevention and treatment of these diseases. To eﬀ ectively combat the consequences of the pandemic, it is necessary to develop comprehensive strategies aimed at reducing morbidity and improving public health.

Keywords: metabolic syndrome, obesity, hyperglycemia, COVID-19, progression.

For citation: Mirzaeva, U.Z.; Nasirova, K.K.; Khodjaeva, N.V.; Narimova, G.D. Features of COVID-19 progression in patients with metabolic syndrome: A literature review. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 116-121. DOI: 10.20969/VSKM.2025.18(2).116-121.

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УДК: 612-008.312.2:575.113.1 DOI: 10. 2096 9/VSKM.2025.18(2).122-129

Role of SNP markers on chromosome 10 in the pathogenesis of atrial fibrillation

Aida R. Sadykova1, Darya A. Ryazanova1, Regina I. Yusupova1, Maxim A. Makarov1, Ramil V. Gataoullin2, Nailya F. Mardanova2

1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia

2City Clinical Hospital No. 11, 34/24 Maximov str., 420127 Kazan, Russia

Abstract. Introduction. Studying genetic factors favoring atrial fi brillation not only contributes to the expansion of our knowledge about the causes of the disease, but also opens up opportunities for the individualized prediction of its development. Increased attention to the genetic aspects of atrial fi brillation is primarily due to the lack of knowledge about the etiology and pathogenesis of atrial fi brillation and the annual increase in the number of patients diagnosed with this disease. Aim. Analyzing the studies on the infl uence of SNP markers on chromosome 10 upon the pathogenesis of atrial fi brillation. Materials and Methods. Analysis of scientifi c publications on the infl uence of SNP markers on chromosome 10 upon the pathogenesis of atrial fi brillation. Results and Discussion. When studying the genetic component in the pathology of atrial fi brillation, it was found that most (more than 11) SNP markers are located on chromosome 10. Each of them encodes proteins involved in the process of contraction and/or impulse transmission. The most well-studied genes are MYOZ1 encoding the protein myozenin 1 involved in calcineurin signal transduction and interacting with proteins on the Z-disc of the cardiac sarcomere, including α-actinin and γ-fi lamin; and SYNPO2L, a gene that encodes the protein sequence synaptopodin 2 acting as a hub protein involved in arranging and anchoring actin in the cell, and potentially necessary for the correct localization of α-actinin. Genes NEURL, associated with PITX2, VCL, and Cav1 and Syne2, the functional role of which remains unclear to this day, are also involved in the development of atrial fi brillation. Conclusions. One of the etiological factors in the development of atrial fi brillation is a genetic predisposition associated with genes located on chromosome 10, which encode proteins that are part of sarcomeres or represent signaling molecules in impulse transmission in the heart.

Keywords: atrial fibrillation, genes, SNP markers.

For citation: Sadykova, A.R.; Ryazanova, D.A.; Yusupova, R.I.; et al. Role of the SNP markers on chromosome 10 in the pathogenesis of atrial fi brillation. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 122-129. DOI: 10.20969/VSKM.2025.18(2).122-129.

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УДК: 616.33-002.5:578.834 DOI: 10.2 0969 /VSKM.2025.18(2).130-135

Current trends in the development of midface complications in post-COVID-19 patients: A literature review

Lalita R. Yunusova1, Bahodir A. Khalmanov1, Gayrat O. Ikramov1, Guzal B. Khaidarova2, Kaim J. Suvonov1

1Tashkent State Dental Institute, 103 Maxtumkuli str., Yashnabad District, 100047 Tashkent, Uzbekistan

2Tashkent Medical Academy, 2 Farabi str., Olmazar District, 100109 Tashkent, Uzbekistan

Abstract. Introduction. COVID-19 can cause both systemic and localized complications, including midface region conditions, such as maxillary osteomyelitis and infections. These issues are exacerbated by metabolic disorders and chronic inflammation associated with post-COVID syndrome. The aim of the study was to examine current trends in the midface region complications in post-COVID-19 patients, based on a review analysis. Materials and Methods. Scientific publications were searched for in databases, such as Web of Science, PubMed, and RSNA, using the following keywords: osteomyelitis, maxilla, complications, and COVID-19. A total of 150 articles were identifi ed. After excluding duplicate entries (15 articles) and publications with insuﬃ cient data (85 articles), 50 of the most relevant sources were included in the analysis. Results and Discussion. Recent studies indicate that post-COVID-19 patients are at an increased risk of developing complications in the midface region, such as maxillary osteomyelitis and other infectious lesions. These issues may stem from chronic infl ammation, immune system dysfunction, and vascular abnormalities triggered by the infection. Individuals with hypertension, diabetes mellitus, and other metabolic disorders are particularly vulnerable due to the systemic infl ammation and microcirculatory impairments. These fi ndings highlight the need for early diagnosis, preventive measures, and comprehensive management of midface complications in patients recovering from COVID-19. Conclusions. Post-COVID-19 patients are at an increased risk of developing complications in the midface region. These fi ndings highlight the importance of early diagnosis and a comprehensive approach to tre atment, including prevention and risk factor management.

Keywords: osteomyelitis, maxillofacial region, complications, COVID-19.

For citation: Yunusova, L.R.; Xalmanov, B.A. ; Ikramov, G.O.; et al. Current trends in the development of midface complications in post-COVID-19 patients: A literature review. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 130-135. DOI: 10.20969/VSKM.2025.18(2).130-135.

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ORGANIZATION OF HEALTHCARE

УДК: 617-089 DOI: 10.20969/VSKM.2025.18(2). 136-144

Clinical and statistical analysis of emergency surgeries in the Republic of Tatarstan

Andrei A. Anisimov1,2, Sergey V. Dobrokvashin2, Andrey Yu. Anisimov1

1Kazan (Volga Region) Federal University, 18 Kremlevskaya str., 420008 Kazan, Russia

2Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia

Abstracts. Introduction. An objective analysis of the dynamics of key statistical indicators of the surgical service in an economically developed region of the Russian Federation serves as a tool for improving emergency surgery results and reducing adverse outcomes in emergency surgery. The aim of this study is to analyze the dynamics of statistical indicators characterizing the provision of emergency surgical care in the Republic of Tatarstan in comparison with the entire Russian Federation and with the Volga Federal District in 2018-2022. Materials and Methods. The study analyzed data from the oﬃ cial and operational medical statistics of the Russian Federation and the Republic of Tatarstan for the period of 2018-2022. Information was used that was taken from annual oﬃ cial reports on the activities of the surgical service of the Chief Surgeon of the Ministry of Health of the Republic of Tatarstan. Results and Discussion. In the Republic of Tatarstan, surgical care, including emergency care, is provided according to a three- level organizational system. Between 2018 and 2022, the number of surgeons in the Republic of Tatarstan decreased by 26 (6.1%), from 428 to 402. Analysis of the long-term dynamics of the proportion of surgical patients hospitalized later than 24 hours after the disease onset indicates a consistently high level of late hospitalizations of surgical patients. Most qualitative and quantitative indicators characterizing surgical care declined over the two years of the pandemic. At the same time, the Republic of Tatarstan managed to stabilize the number of deaths in general surgical beds, the number of operated patients with acute abdominal conditions, the number of deaths after surgeries, and the number of outpatient visits to surgeons. The reduction in hospital mortality caused by emergency abdominal pathology contributed to the decrease in overall mortality and mortality caused by digestive diseases in 2022. Conclusions. The most signifi cant challenges the surgical service faces in the Republic of Tatarstan are the shortage of personnel and late presentation of patients with emergency surgical conditions, both of which reduce the quality of emergency surgeries. In the economically developed region of the Russian Federation, from 2018 to 2022, despite higher rates of COVID-19 morbidity in 2021, hospital mortality decreased in fi ve out of seven emergency surgical conditions of “acute abdomen,” key qualitative and quantitative indicators were stabilized, and the availability of emergency surgical care was ensured.

Keywords: surgery, emergency su rgery, mortality, lethality.

For citation: Anisimov, A.A.; Dobrokvashin, S.V.; Anisimov, A.Yu. Clinical and statistical analysis of emergency surgeries in the Republic of Ta tarstan. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (2), 136-144. DOI: 10.20969/VSKM.2025.18(2).136-144.

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