Vol 6, №2

Objective. To assess the work of the cardiology service in the context of the prevalence of cardiovascular diseases in the Republic of Tajikistan.

Materials and Methods. This study is based on official statistical data, reports of the cardiology service of the Republic of Tajikistan and the State Institution “Republican Clinical Center of Cardiology” for the period from 2020 to 2024. The results of the two-stage epidemiological study STEPS, developed by the World Health Organization, were also used.

Results. Over the past 10 years, there has been a decrease in the incidence of cardiovascular diseases in general, as well as arterial hypertension, coronary heart disease, myocardial infarction, etc. Despite the increase in the prevalence of arterial hypertension in 2017 and a slight increase in 2022, over the past 10 years we have seen a trend towards a decrease in incidence by 37%. There has also been a decrease in the prevalence of coronary heart disease from 530.1 to 181.5 cases per 100 thousand people, and its acute form — from 36.8 to 3 cases per 100 thousand.

Over the past five years, there has been a wave-like dynamics of growth and decline in the primary incidence of cardiovascular diseases. During this period, the overall incidence increased by 35% (by 68,059 people), which, when recalculated per 100 thousand of the population, is 18.4% (by 466.3 per 100 thousand).

Analysis of statistical data on mortality from cardiovascular diseases in the Republic of Tajikistan for the period from 2014 to 2023 shows the following trends. In 2015, there were 190.3 cases of death from cardiovascular diseases per 100 thousand of the population. Then, in 2020, there was a sharp jump in mortality — 205.9 cases per 100 thousand of the population. In 2021, a slight decrease in the incidence rate was recorded — 194.5 cases per 100 thousand people. This decrease in incidence coincided with the period of the COVID-19 pandemic.

Conclusion. Currently, the cardiology service of Tajikistan pays special attention to three key areas: further development of preventive cardiology; introduction of modern endovascular technologies in cardiology; improving the quality and availability of medical care for patients with cardiovascular diseases.

Objective. Assessment of environmental and sanitary conditions in the area of the Tajikcement cement plant.

Materials and Methods. The study was conducted in 2024. Specialists from the environmental protection committee of the Tajikcement cement plant took part in it. The concentration of chemical particles was measured in the working areas of the main and auxiliary workshops of the cement plant.

Results. Several types of winds prevail on the territory of the Tajikcement cement plant. The most common type is the “Northern” wind at a speed of 3-4 m/s. It promotes uniform distribution of pollution in the working areas. The second type of wind is “Garmsila”. It blows at a speed of up to 1-2 m/s from west to east. This wind also has a negative impact on workers. In addition, in the south of Tajikistan, a southern or south-western wind sometimes occurs, which is called “Afghan”. It also affects the wind conditions in the area of the cement plant.

Studies have revealed many toxic substances in cement dust, among which the most dangerous are aluminum, cadmium, lead, silver and strontium. High concentrations of harmful particles were found in the air. Among them: carbon monoxide (1.3 mg/cm³), sulfur dioxide (0.08 mg/cm³), nitrogen oxide (0.07 mg/cm³) and solid fluorides (0.07 mg/cm³). At the cement plant, an increased content of toxic microparticles was found in the air of working areas. This is especially noticeable in the crushing zone (165.0 mg/m³), in the general area of the workshop (157.1 mg/m³), in the packaging shop and on linear conveyors (120.5 mg/m³) and in the loading zone (111.2 mg/m³).

Conclusion. The greatest health hazards for workers in the main and auxiliary shops are carbon monoxide, sulfur dioxide, nitrogen oxide and solid fluorides. These substances can cause respiratory diseases. Some of them can cause allergies and lead to broncho-obstructive syndrome.

Objective. Study of some mechanisms and course of bacterial translocation and disruption of the liver barrier function with subsequent correction in widespread purulent peritonitis.

Patients and Methods. A retrospective and prospective study was conducted based on data obtained from the examination and treatment of 69 patients with widespread purulent peritonitis who were hospitalized in the surgical departments and the liver and pancreas surgery department of the Dushanbe City Emergency Medical Care Center. The study covered the period from 2014 to 2024.

Results. According to the microbiological analysis, a high prevalence of gram-negative bacteria was noted: Escherichia coli was detected in 59 cases (85.5%) as a monoinfection and in 7 cases (10.1%) in combination with other microorganisms; Streptococcus faecalis was detected in 18 cases (26.0%) as a monoinfection and in 5 cases (7.2%) in combination with other bacteria. The highest sensitivity of bacteria to the most frequently used antibacterial agents was noted for meropenem and imipenem — in 86.9% and 86.2% of cases, respectively.

All patients with widespread purulent peritonitis developed severe visceral circulation disorders: blood flow in the superior mesenteric artery decreased by 47.1±2.8%, 351.20±18.59 ml/min, total hepatic blood flow – by 57.1±2.5%, 680.30±38.42 ml/min, portal blood flow – by 71.3±2.2%, 332.20±26.22 ml/min, hepatic arterial blood flow – by 18.3±4.0%, 348.10±16.71 ml/min compared to healthy individuals, which indicated a severe disorder of organ hemodynamics in the liver and small intestine.

Conclusion. In the pathogenesis of visceral function disorders in widespread purulent peritonitis, an important role is played by organ circulation disorders, massive translocation of intestinal microflora into the arteriovenous bed, and acute liver failure, manifested primarily by macrophage liver failure.

Objective. To analyze the results of surgical treatment of patients with venous-cavernous hemangiomas of different localizations.

Patients and Methods. Over the past five years, we have operated on 18 patients with venous-cavernous hemangiomas of various localizations. Two of them underwent repeated surgery due to relapses. The patients’ ages ranged from 7 to 29 years, with an average age of 17.2±4.6 years. Hemangiomas ranged in size from 3 to 8 centimeters, and most of them were located under the skin. Only in four cases did hemangiomas on the shin and thigh grow into muscle tissue.

Results. In all patients, the hemangioma was at different depths and did not affect the skin. We used the treatment tactics used in the republican specialized clinic: 1. Sclerotherapy as the only method; 2. First sclerotherapy, then surgery; 3. Only surgical treatment. In two patients with hemangiomas in the lower third of the thigh, deep tumors invading the medial muscles were detected during surgery. Postoperative results were good in all cases. No recurrences of hemangiomas were recorded during the observation period.

Conclusion. With appropriate equipment and an experienced vascular surgeon, venous cavernous hemangiomas can be successfully operated on in a regular surgical department. A two-stage treatment, including sclerotherapy and subsequent surgical excision, provides safety and better results.

Objective. To study of etiological factors that determine unfavorable treatment outcomes in patients with generalized peritonitis.

Patients and Methods. A total of 188 patients with widespread peritonitis were examined. The diagnosis was established clinically by objective examination, confirmed radiologically by detecting free air under the diaphragm and/or free fluid in the abdominal cavity by ultrasound, as well as by the results of additional research methods.

Results. Most patients 137 (72.9%) were hospitalized within 24 hours of illness. Abdominal pain as the most common symptom was diagnosed in 180 (95.7%) patients with peritonitis. Shock was recorded in 11 patients (5.8%) with systolic blood pressure below 90 mmHg and heart rate above 100 beats per minute. Fever was detected in 39 patients (20.7%). The average length of hospital stay was 11.5 days; the longest hospital stay was 37 days and the shortest was 1 day.

The most common etiologic factors of secondary widespread peritonitis are perforation of gastroduodenal ulcers (n=70; 37.2%), acute intestinal obstruction (n=54; 28.7%), destructive appendicitis (n=46; 24.5%). Among the many clinical and laboratory factors that influence mortality, the authors highlight the most significant ones: severe concomitant diseases, the stage of peritonitis and postoperative complications that cause death.

Conclusion. Severe concomitant diseases and postoperative complications cause death and, therefore, upon admission of patients, a thorough anamnesis must be collected to identify severe concomitant diseases in order to take timely measures to prevent postoperative complications and death.

Objective. Analysis of the results of the online survey “Actual Phlebology” on hardware complications during endovenous laser obliteration.

Materials and Methods. 1,558 surgeons and phlebologists from the CIS countries took part in the survey on the website “Actual Phlebology Online”, which was conducted anonymously. The survey was conducted online in 2025.

Results. The study revealed that in 51.2% of cases, doctors encountered technical complications. In 65 cases (81.3%), the cause of damage to the fiber during surgery was repeated sterilization. Manufacturing defects of the fiber were observed in 53 cases (66.3%), damage by a needle during anesthesia — in 32 cases (40%), and excessive aggression when inserting the fiber during surgery — in 30 cases (37.5%). 48.1% of respondents believe that the percentage of complications is from 0.01 to 0.1%.

According to 52.4% of surgeons and phlebologists surveyed in the study, the responsibility for complications due to equipment failure or breakdown lies with the doctors themselves. 31.7% of respondents believe that medical institutions should be held responsible for this. 15.9% believe that the manufacturer of low-quality laser equipment and spare parts is to blame. The majority of respondents (83.7%) said that they do not use such equipment in their practice. The majority of respondents (83.7%) do not use a device for measuring power. However, every sixth (16.3%) of them can determine the technical characteristics of a radial light guide.

Conclusion. An analysis of the results of an online survey of surgeons and phlebologists who use endovenous laser obliteration revealed the main causes of hardware complications. These are non-compliance with the procedure protocols, repeated sterilization of radial light guides, damage to the light guide by a needle during anesthesia, and technical defects of the light guide.

Objective. To determine indications for different types of reconstructive surgeries for the consequences of electrical injury to the fingers and hand, and to improve long-term treatment results.

Patients and Methods. From 2020 to 2024, we examined 72 patients with sequelae of electric shock to the upper limb. Of these, 17 had contractures of the wrist and fingers. In 7 cases, the structures of the wrist were damaged, and in 10 cases, the finger structures were damaged. Skin defects aggravated the severity of injuries.

Results. Indications for a one-stage operation were identified in 12 patients with contractures of the wrist joint (in 7 cases), as well as I (2 cases), II-III (1 case) and I-V (2 cases) fingers. In the five remaining cases of contractures of I-V and II-V fingers, the operations were divided into two or three stages. The choice of method depended on the local resources of the hand and fingers, the length of the cicatricial defect and the number of fused fingers.

In 12 cases, after eliminating contractures of the wrist and fingers, the defects were closed using local tissues. Dividing the operation into stages made it possible to abandon the use of transposition flaps. Instead, local plastic surgeries were supplemented with free skin grafting. In five cases, when eliminating contractures of the wrist joint (two cases) and fingers (three cases), an axial non-free inguinal flap was used to close the skin defects that formed after eliminating the contractures.

Conclusion. The key point in the treatment of patients with the consequences of electrical trauma is the determination of the indications and the sequence of the stages of the operation. The best results were achieved in the correction of isolated contractures of the wrist and thumb. Transposition flaps and an axial inguinal flap were used for this purpose.

Objective. To study the features of cellular immunity in children suffering from psoriasis and changes in apoptosis (CD95) and phagocytosis (CD32) indices in predicting relapses of this dermatosis.

Materials and Methods. A total of 65 patients aged 7 to 18 years suffering from various forms of psoriasis were examined. Flow cytometry (CYTOMICS FC500) using MAB conjugates was used to assess immune indices and determine the percentage of CD95 and CD32 parameters. The control group included 30 healthy children of the same age who underwent similar studies.

Results. Children with psoriasis showed significant abnormalities in apoptosis and phagocytosis compared to healthy peers. At 15.0±8.5 days after the start of treatment, 41 of 65 (63.0%) children with psoriasis showed a two-fold decrease in CD95 and CD32 compared to baseline values.

These patients had a 2.6-fold decrease in the number of relapses over a 12-month period compared to the group of patients who did not show a significant decrease in CD95 and CD32 levels (11 of 41 cases; 26.8% vs. 17 of 24 cases; 70.8%).

Conclusion. Early detection of immune abnormalities allows for the optimization of an individual treatment plan and increased effectiveness of long-term disease control.

Objective. To study the species composition and antimicrobial properties of the hand skin microflora in children studying in comprehensive schools.

Materials and Methods. The study was conducted among 40 schoolchildren from the State Educational Institution “Secondary Comprehensive School No. 94”. Skin swabs and forearm prints were taken for analysis. Sowing was carried out on Endo medium, blood agar, salt agar with mannitol and Sabouraud agar.

Results. In 21 schoolchildren, the number of microbes was within 2-10. Staphylococcus epidermidis, Staphylococcus saprophyticus and other saprophytic cocci, such as tetracocci, sarcins and micrococci, predominated on their skin. In 8 students, the microbial count reached 50-60, which was accompanied by an increase in the number of Staphylococcus aureus. An increase in single strains of Streptococcus haemolyticus was also observed. In 9 schoolchildren, which is 22.5%, the number of microbes on the skin was within 80-90.

Strains of St. haemolyticus, S. aureus and mold fungi Mucor were found in their microbial flora. Only 5% of students, in two cases, had a microbial count of 120-130. They were found to have growth of gram-negative bacteria of the genus Klebsiella, as well as E. coli, which are often found together with coccal microorganisms. Only 52.5% of schoolchildren had a level of microbial contamination of the skin within the normal range. 20% of schoolchildren had a moderately high level of microbial contamination, 22.5% had an increased level, and 5% had a significantly increased level. 40% of children have low skin resistance.

Conclusion. The study revealed different levels of skin colonization in schoolchildren. Among the microorganisms found were Staphylococcus aureus, hemolytic Staphylococcus aureus, Klebsiella, Escherichia coli and Mucor fungi. An assessment of the antibacterial activity of the skin in younger schoolchildren revealed low resistance. This may increase the risk of developing various diseases.

The review article presents a pharmacological characteristic of the plant of the genus Kotovnik (Nepeta). Nepeta is one of the largest genera of the family of clear (lamiáceae) or labiátae (Labiátae). In the Republic of Tajikistan, 32 different types of Kotovnik (Nepeta) are growing, of which 25 are perennial plants, 9 species are endemics, and only seven are annuals.

The plant of the genus Nepeta has a wide range of biologically active properties. It relieves inflammation, relieves pain, fights bacteria, fungi and viruses. It also neutralizes free radicals, prevents blood clots and reduces blood sugar levels. It also acts as an antihelminthic agent, protects the heart, has a cytotoxic effect and can destroy cancer cells. In addition, the drug promotes apoptosis (natural cell death), maintains liver health and strengthens the immune system.

The analysis of the literature showed that the products obtained from the Kotovnik family can potentially act as an alternative to modern cardiprotective drugs. Thus, alcohol extract prevents damage to heart tissue, isopurenol, replenishing endogenous antioxidants, stopping lipid oxidation, reducing inflammation and inhibiting apoptosis by reducing the regulation of NF-κB universal transcription factor that controls the genes of immune response, apoptosis and cellular cells cycle.

Objective. Evaluation of hepatoprotective, antitoxic and anti-inflammatory properties of tagetol in experimental conditions in rats poisoned with tetrachloromethane (CC1₄).

Materials and Methods. To clarify some mechanisms of the hepatotropic effect of tagetol, which is based on the rhizome of a small-flowered plant growing in the Republic of Tajikistan.

Results. When assessing the effect of tagetol on the enzymatic function of the liver, it was found that during subacute intoxication of animals with CC1₄, a statistically significant change in the activity of the enzymes ALT, AST is observed — by 51.8%, 48.7%, 44.0%, 39.0% and alkaline phosphatase — by 48.0%, 39.11%, respectively.

A comparative analysis shows that under the influence of the indicated doses of the test agent, the activity of malondialdehyde during two-month intoxication, compared with the control data, decreases by 39.0%, 34.0%, and the levels of catalase and SOD increase by 57.1%, 58.7%, 64.2%, 55.3%, respectively.

With a month-long treatment with tagetol, small foci of protein and fatty dystrophy are observed, in some areas signs of hepatocyte regeneration and accumulation of binuclear cells are visible. In organ sections that received tagetol for 60 days, active regeneration of hepatocytes and the absence of signs of protein and fatty dystrophy were found.

Conclusion. Tagethol has significant hepatoprotective properties, helps to reduce the activity of liver enzymes and improves histomorphological indices of hepatocytes impaired by carbon tetrachloride.

Objective. This article discusses the issues of timely and accurate diagnosis of traumatic urethral strictures.

Results. Accurate visualization of urethral stricture diagnostics is crucial for preoperative staging, choice of surgical approach and reconstruction planning.

The choice of visualization method should depend on the etiology, localization, general condition of the patient and the type of urethral injury. Rational combination of different visualization methods can improve the accuracy of traumatic urethral stricture diagnostics.

Currently, radiography, retrograde urethrography, voiding cystourethrography, magnetic resonance urethrography and sonourethrography are used to diagnose urethral strictures.

Conclusion. Imaging plays a central role in the evaluation of suspected urethral stricture, as the assessment of the length and severity of the stricture is critical to determine surgical treatment. Given the increasing number of patients with urethral stricture, improved diagnostic methods are needed to guide the selection of the optimal treatment.

Hypospadias is characterized by a combination of several abnormalities: a curvature of the penis (chordee), a deficiency of foreskin skin on the underside of the glans penis (dorsal hooded foreskin), and an abnormal location of the urethral opening, which is closer to the base of the penis than normal. The severity of these features may vary.

The ventral part of the penis is often lined by underdeveloped shaft skin. In many situations, anterior displacement of the scrotum is observed, leading to penoscrotal transposition. This indicates possible problems in the process of sexual development.

A mild form of hypospadias, in which the urethral opening is located on the head of the penis and there is no chord, usually has a favorable prognosis and does not require surgical correction, does not have a significant functional impact. Severe forms of penile curvature lead to significant deformation, which negatively affects sexual activity and urination. Treatment of such cases may include serious surgical methods to correct the curvature and restore erectile function.

There are different methods of correction of penile curvature, which include ventral penile lengthening by corporoplasty using corporal grafts (dermal, vaginal tunica graft), ventral corporal incisions, or dorsal shortening by corporal plication. Staged reconstructions have been shown to achieve better results overall.