Vol 5, №3

Objective. Assessment of the main performance indicators of the Emergency Medical Care Center of the Rudaki District of the Republic of Tajikistan.

Materials and Methods. The analysis used data from annual statistical reports, including information on the frequency of diseases registered in patients living in the service area of the Emergency Medical Care Center in the Rudaki District, for the period from 2019 to 2024.

Results. In 2024, the number of people seeking emergency medical care increased to 7,467 people. This is 24.5% more than in 2019, when there were 5,998 such requests. In this area, the most common diseases are cardiovascular diseases, especially hypertension, which leads in the number of requests among the population of Rudaki, showing an increase of 19.0%. Next come respiratory diseases, the number of which increased by 1.8-2 times. Coronary heart disease, on the contrary, has become less common by 1.8 and 2.7 times. Chronic kidney diseases remain at a consistently high level. Diseases of the abdominal organs also show an increase – by 1.7 and 2.0 times. Over the past year, the number of poisoning cases has decreased by 3 times. At the same time, the number of limb injuries has increased by 2.2 times. A noticeable increase in the number of patients seeking medical help due to nervous and mental illnesses is worrying. In the Rudaki district, this figure has doubled.

Conclusion. The results of the Center’s work in recent years have shown that it has significantly expanded the scope of its activities. This has significantly increased the availability of medical care, which has led to an increase in the number of requests from residents of the district. To prevent the most common diseases, it is necessary to strengthen health education work among the population.

The article examines modern research devoted to one of the current problems – feeding children with congenital malformations of the maxillofacial region, in particular with cleft lip and palate. The various approaches and methods used to feed these infants are described, with particular attention to the problems that may arise when using a nasogastric tube, as well as the advantages of breast milk and alternatives to artificial feeding.

This literature review examines the latest scientific evidence on target organ damage in hypertension. Particular attention is paid to left ventricular hypertrophy, coronary microvascular dysfunction, subclinical systolic dysfunction, and microalbuminuria as factors contributing to the development of heart failure with preserved ejection fraction. Arterial hypertension is a major risk factor that can lead to heart failure, one of the leading causes of death and disability worldwide. Long-term overload of the heart and blood vessels with elevated blood pressure causes structural and functional changes in the cardiovascular system, known as hypertensive target organ damage. The main factors determining this condition are left ventricular hypertrophy, coronary microvascular dysfunction and subclinical left ventricular systolic dysfunction. Left ventricular hypertrophy is an independent risk factor for the development of cardiovascular complications. In addition, microalbuminuria, which indicates renal dysfunction, is closely associated with the occurrence and poor prognosis of HFpEF.

Objective. Evaluation of the results of microsurgical reconstruction of upper limb nerve trunks with distal injuries accompanied by complete anatomical rupture.

Materials and Methods. During the period 2006–2024, 109 patients (129 nerve trunks – NT) with distal injuries of the nerves of the upper limbs were operated on. Depending on the location of nerve damage, in many cases the most common injuries were to the median nerve (n=63; 48.8%) and ulnar nerve (n=44; 34.1%), followed by the radial nerve (n=22; 17.1%), as well as combined damage to the median and ulnar nerves (n=20; 18.3%). According to the reconstruction method, in 47 cases (57 NT) it was necessary to apply an emergency suture on the nerve (group I), in 28 cases (34 NT) – a delayed suture on the nerve (group II), and in 34 cases (38 NT) autologous neuroplasty was used (group III).

Results. In 96.5% of cases, emergency nerve restoration in children with distal injuries leads to excellent and good results. The results of delayed nerve reconstruction using the end-to-end method or autonerve grafting are successful in 82-85% of cases. In 85% of cases, regardless of the severity and timing of damage, complete restoration of anatomy occurs within 18 months.

Conclusion. Distal injuries of the median, ulnar and radial nerves require a special approach due to anatomical features, the method of reconstruction and a short period of regeneration. The use of the developed algorithm allows optimizing surgical approaches to nerve injuries at the distal level, and correctly determining indications for nerve reconstruction using the “end-to-end” method or autonerve grafting.

Objective. To develop a treatment strategy for patients who have had their fingers amputated after errors were made during their transportation.

Materials and Methods. Our study identified 12 patients who faced the problem of inadequate preservation of severed finger segments at the stage of initial medical care. 5 patients (6 fingers) suffered from a middle phalanx injury, and 7 patients (10 fingers) suffered from a proximal phalanx injury. None of them used the cold preservation method.

Results. Finger replantation surgery was performed in 6 patients (7 fingers). In all 3 patients (five fingers), in whom warm ischemia persisted for up to six hours, there were no problems with tissue perfusion. However, in three patients who had warm ischemia for more than six hours, the results of replantation were unsatisfactory.

Conclusion. Clinical assessment is important for making a decision on replantation of an amputated part. One of the key factors determining the successful outcome of the operation is the storage of the amputated finger at a low temperature.

The literature review is devoted to summarizing the results of modern research on the diagnosis of acute chronic pancreatitis in order to optimize the diagnosis and treatment of pregnant women, taking into account the complexity of diagnostics in the pancreatobiliary system. The literature review touches on the issues of ethiopathogenesis, clinical manifestation of pancreatitis in various difficult circumstances of pregnancy, the cause of which is often cholelithiasis. Data on the use of ultrasound, MRI CP, ERCP and papillosphincterotomy at various stages of pregnancy are presented. The authors adhere to active tactics for the diagnosis and treatment of acute pancreatitis, which help reduce complications of both maternal and perinatal mortality.

The review article highlights modern approaches to surgical treatment of large and giant ventral hernias. Along with the study of the shortcomings of local plastic surgery methods for the correction of large and giant ventral hernias, the possibility of using tension-free surgery methods is substantiated. A special place is occupied by issues related to the types of polymer prostheses, indications for their use, advantages and disadvantages of transplants. At the same time, the prospects of tension-free hernioplasty methods, in particular endoscopic low-traumatic hernia correction methods, are shown. Despite the improvement of traditional, as well as the use of modern, including endoscopic methods of surgery, to this day, many areas of this problem remain unsolved, in particular, the causes of hernia development, relapse of pathology and a number of complications that developed in the early and late postoperative period.