Vol 5, №4

Materials and Methods: The study analyzed official statistical data for a ten-year period from 2014 to 2023. In addition, the long-term experience of primary health care aimed at ensuring universal access to health services for the country’s population was studied. To assess the effectiveness of this work, seven indicators were selected from the sixteen essential health services recommended by the World Health Organization (WHO). These indicators are divided into four categories. This study reviewed and analyzed data on three national indicators: the network of primary health care facilities; provision of qualified personnel; and financing.

Results: In the healthcare system of the Republic of Tajikistan, the main burden of ensuring UHC falls on the primary level. It provides a basic package of medical services. There are 5,201 medical institutions in the country, which serve 10.288 million people living in the republic as of 2024. As of December 1, 2024, 22,003 doctors and 63,434 mid-level medical personnel work in medical institutions of the country. The primary health care is represented by 3,009 institutions, which is 58.3% of the total number of public and private medical organizations. These institutions employ 12,579 doctors, which corresponds to 57.1% of the total number of specialists, and 36,385 nurses, which is 57.4%.

Over the past ten years, funding for primary health care (PHC) institutions has increased from 15.9% (in 1998) to 40% (in 2024). According to the list of key indicators for universal health coverage, 93.9% of PHC institutions were built or renovated, and 89.0% were re-equipped with the necessary equipment. The total funding amounted to 1.29 billion somoni.

Conclusion: In the Republic of Tajikistan, a number of measures are being implemented aimed at ensuring universal access of the population to quality health services in priority areas.

Material and Methods: 114 women aged 18-39 years with abnormal vaginal discharge and 31 healthy women were examined. The microbiocenosis of vaginal discharge and feces was studied. The SHK reaction was performed, succinate dehydrogenase and acid phosphatase of immunocompetent blood cells, interleukins IL-1 (β), IL-4, IL-8, IL-10 were determined. The personal and situational anxiety, neuroticism and depression were studied.

Results: Main causes of abnormal vaginal discharge were bacterial vaginosis, aerobic vaginitis, vulvovaginal candidiasis and trichomoniasis. Disease was accompanied by disturbances in vaginal and intestinal microbiome. Disturbances in the activity of energy supply and hydrolysis enzymes in granulocytes and blood lymphocytes were found. The prevalence of pro-inflammatory interleukins was noted, which leads to a violation of the immune response and prolonged inflammatory process. The violation of the psychological state of patients was revealed.

Conclusion: Abnormal vaginal discharge is accompanied by a violation of vaginal and intestine biocenosis, metabolic disorders of immunocompetent cells, increase in serum interleukins, the prevalence of pro-inflammatory interleukins over anti-inflammatory, psychological disorders. After 3 months of therapy women with abnormal vaginal discharge had better results in the biocenosis and metabolic disorders, decrease in the levels of serum interleukins.

Materials and Methods: In a retrospective study conducted from 2016 to 2021, 286 men over 50 years of age suffering from gout and visiting the State Medical Center No. 2 named after K.T. Tadzhiev were examined. All patients were divided into two groups depending on the presence or absence of arterial hypertension (AH): the first group included 244 (85%) patients with AH, and the second group included 42 (15%) without it.

Results: Arterial hypertension was detected in 244 (85%) patients. In 129 (52.9%) of them it developed before gout, and in 115 (47.1%) – against the background of an existing disease. Chronic kidney disease was diagnosed in 19 (7.8%) patients from the second group, while no such cases were found in the first group. During the analysis of traditional risk factors for cardiovascular diseases, it was found that patients of the first group more often than patients of the second have an aggravated family history associated with the early development of arterial hypertension, and also suffer from abdominal obesity and obesity according to the body mass index.

Conclusion: Factors that may increase the risk of developing hypertension in people with gout include obesity, positive family history, early onset of hypertension, duration of gout for more than 10 years, onset after age 35, presence of intraosseous tophi, history of chronic kidney disease, and elevated serum C-reactive protein levels. Although associations have been found between gout and hypertension, the cause-and-effect relationship between the two conditions remains unclear. Large randomized clinical trials are needed to better understand this association.

Material and Methods: The study was conducted from 2020 to 2024 at the Republican Clinical Center of Cardiology. The study involved 20 patients with coronary heart disease (CHD) and 20 patients with coarctation heart disease. All participants underwent a stress test with dipyridamole.

Results: A significant predominance of left ventricular asynergy zones was found in 95.0% of patients with coronary heart disease (n=19). An assessment of the kinetics of 320 segments revealed that most of them – 150 (46.8%) contracted with normal amplitude. However, 112 (35.0%) segments were in a state of hypokinesis, 40 (12.5%) – in akinesis, and 18 (5.6%) – in dyskinesis.

After the use of dipyridamole, all patients with myocardial ischemia showed an improvement in left ventricular contractility indices. This was expressed in an increase in the ejection fraction from 1.13±0.07 units to 1.49±0.05 units. The indices of the left ventricular end-systolic volume index and end-systolic size decreased, while the left ventricular contractility index increased to 1.49. In addition, an increase in zones and segments with hypokinesis and akinetic state was recorded.

Conclusion: A pharmacological test with dipyridamole may be useful for the diagnosis of syndrome X, as well as in cases of impaired segmental contractility at rest, unjustified decrease in the left ventricular contractility index, anginal attacks of pain in the heart, the origin of which remains unclear, “silent and painless ischemia” and in atypical forms of the clinical course of ischemic heart disease.

Urolithiasis is one of the most common urological diseases, in which stones (calculi) are formed in the kidneys and urinary tract. There are numerous factors that contribute to the development of this pathology, and among them, anomalies in the development of the kidneys and upper urinary tract are of great importance, such as horseshoe kidney, kidney doubling, dystopic kidney, congenital narrowing of the ureteropelvic segment, etc. With the development of anomalies, there is a violation of the outflow of urine (urodynamics), which creates favorable conditions for stagnation of urine and crystallization of salts.

Materials and Methods: From 2016 to 2024, 120 patients with nail phalanges injuries were examined and operated on in the Department of Reconstructive and Plastic Microsurgery of the Republican Scientific Center for Cardiovascular Surgery. Most patients, namely 80 people (67%), were of active working age from 18 to 45 years. During the operation, the Tranquili-Leali (V-Y) method was used, which involves the use of a sliding triangular flap.

Results: In the remote period, which lasted from 6 months to 1 year, 88.0% of patients achieved a good functional and aesthetic effect after the surgery. Satisfactory results were achieved in 12.0% of patients, even if the finger function was not fully restored, but generally met their needs. Unsatisfactory results were not observed. No repeated interventions were required in the remote periods after the surgery.

Conclusion: The choice of tactics for reconstructing skin and soft tissue defects was determined by the characteristics of the defect itself. In 98.6% of patients for whom the type of reconstruction was correctly selected, it was possible to achieve a good functional and aesthetic result.

Material and Methods: The authors analyzed the results of operations performed between 2022 and 2024 in a clinic in the city of Kuwait (Kuwait) on 28 patients who underwent operations on the lower third of the face and neck. The patients underwent a minimally invasive operation called “aqualifting”. Liquid preparations were used during the procedure. All operations were performed under local anesthesia on an outpatient basis. The age of the patients ranged from 25 to 65 years.

Results: After the swelling had subsided, the patients underwent a follow-up examination three months after the aqualifting procedure. The examination results showed that the tissues had fully recovered, and all facial muscle functions had returned to normal. Complications that arose during the operation did not affect its results.

In the remote postoperative period, the results of all operations performed on patients were studied. In four cases, the aesthetic results were considered unsatisfactory, which was associated with previously performed operations in other medical institutions. The remaining patients who underwent the operation were satisfied with the aesthetic result and did not express any complaints.

Conclusion: Provided that the patient’s condition is properly assessed, aqualifting using tumescent local anesthesia can be safe and effective for almost all age groups. The best candidates for this procedure are people with localized fat deposits, whose skin has good tone and slight laxity of the SMAS and platysma.