Vol 6, №4

Objective. To improve the effectiveness of diagnosis and surgical management of necrotizing fasciitis of the soft tissues.
Materials and methods. We analyzed 68 patients with necrotizing soft-tissue infections: necrotic erysipelas (n=27), necrotizing fasciitis (n=31), and myonecrosis (n=10). Assessment included clinical evaluation, laboratory testing, point-of-care ultrasonography (POCUS), radiography/Doppler studies, transcutaneous oxygen tension (TcPO₂; mean 35.8±2.4 mmHg prior to reconstructive procedures), wound microbiology with antibiograms, and cytology of wound exudate. Surgical strategy comprised emergent wide necrectomy with repeat explorations within the first 12–24 hours, drainage, and negative-pressure wound therapy (NPWT); when indicated, split-thickness skin grafting with perforated autografts was performed.
Results. Early POCUS detected fluid collections within fascial planes and soft-tissue gas, expediting urgent surgery (in most cases within 6 hours of admission). NPWT facilitated rapid control of exudation, maturation of granulation tissue, and readiness for coverage: complete graft take occurred in 75% of cases and partial take in 18.7%. Major amputations were required in 13 patients; overall mortality was 23.5% (16 deaths). Cytology reflected a shift from acute purulent inflammation to reparative changes (increased macrophages and fibroblasts) during therapy.
Conclusion. A comprehensive algorithm—early POCUS verification → immediate radical necrectomy with staged re-explorations → NPWT → selective reconstruction—combined with etiotropic antibiotic therapy tailored to local susceptibility patterns, improves infection control, reduces local complication rates, and enhances preparedness for reconstructive procedures in patients with necrotizing soft-tissue infections.

Objective. To determine the prognostic significance of glycated hemoglobin (HbA1c) levels in assessing the risk of adverse cardiovascular outcomes in patients with type 2 diabetes mellitus who have had acute coronary syndrome.
Materials and Methods. A prospective study analyzed data from 72 patients with type 2 diabetes mellitus and acute coronary syndrome. Patients were divided into two groups: the first group included patients with glycated hemoglobin (HbA1c) ≤7% (n=21), and the second group included patients with HbA1c >7% (n=51). The groups were balanced for key clinical characteristics.
Results. In patients with HbA1c level >7%, statistically significantly higher scores were found on the SYNTAX (27.2±6.60 vs. 24.3±5.00; p=0.048) and GRACE (114.8±22.3 vs. 105.4±19.0; p=0.041) scales. The frequency of adverse cardiovascular events during the hospital period did not differ, but after 12 months it was significantly higher in the group with HbA1c >7% (29.4% vs. 14.3%; p=0.022). Correlation analysis confirmed significant direct relationships between the HbA1c level and SYNTAX (r=0.385; p<0.001) and GRACE (r=0.275; p=0.019) scores.
Conclusion. HbA1c levels are an important indicator of the severity of coronary atherosclerosis and the risk of cardiovascular complications in patients with type 2 diabetes and acute coronary syndrome. The study results convincingly support the need for strict glycemic control, which can significantly improve the prognosis for this group of patients.

Objective. To analyze the dynamics of changes in the level of high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 in patients with various clinical manifestations of coronary heart disease.
Materials and Methods. The study involved examining 30 patients with various stages of coronary artery disease (CAD). The average age of the participants was 63.4±1.5 years, and all had documented CAD. Patients were selected from each clinical form of the disease: 10 people with CAD. Angina pectoris functional class II, 10 people with small-focal myocardial infarction in the acute period, and 10 people with large-focal myocardial infarction, complicated. The study included 12 women (40.0%) and 18 men (60.0%).
Results. Studies show that as coronary artery disease progresses, from initial ischemic processes to the development of myocardial necrosis, an increase in the concentration of nonspecific inflammatory markers is observed. The highest levels of C-reactive protein are observed in patients with complicated forms of myocardial infarction, reaching 8.2±0.25 mg/L and exceeding control values by 3.3 times. Interleukin-6 concentrations also increase significantly, reaching a maximum in the group of patients with complicated myocardial infarction, averaging 24.2±0.34 pg/ml, which is 3.1 times higher than control values.
Conclusion. The cytokine interleukin-6, in combination with high-sensitivity C-reactive protein, are the most reactive markers, allowing them to be used as important factors in the development and progression of coronary artery disease. Determining CRP and IL-6 levels is essential for predicting the risk of vascular complications.

Objective. To evaluate the effectiveness of simultaneous videoendoscopic nephrectomies for pathologies of the kidneys and other organs of the abdominal cavity and retroperitoneal space, the quality of life of patients and the cost/effectiveness ratio of such operations using various methods.
Materials and Methods. The study included 37 patients suffering from combined surgical diseases of the abdominal organs and retroperitoneum.
Results. Laparoscopic nephrectomies offer the following advantages over staged and traditional methods: the average duration of surgery is reduced by 1.47 times (p<0.001); blood loss during operations using the LPN is reduced by 2.21 times compared to traditional methods, and by 1.19 times when using the new approach. Postoperative patient recovery time is reduced by 1.29 times, and the number of hospital days is reduced by 1.3 times. A reduction in intra- and postoperative complications is also noted, and cost effectiveness is increased by 1.2 times.
Conclusion. The use of videoendoscopic simultaneous surgeries for the treatment of concomitant abdominal and retroperitoneal diseases, provided the appropriate treatment method is selected for selected patients, contributes to improved medical and social outcomes. This reduces the risk of complications, promotes faster patient recovery, shortens hospital stays, and increases the cost-effectiveness of treatment. As a result, patients significantly improve their health and return to a full life.

Objective. To study the prevalence, structure, and clinical-laboratory characteristics of cardiorenal-metabolic multimorbidity in hospitalized cardiology patients.
Materials and Methods. A retrospective study was conducted involving 780 patients hospitalized in a cardiology department. A detailed analysis was performed of demographic indicators, anthropometric data, lifestyle factors, comorbidity structure (with emphasis on chronic heart failure – CHF, atrial fibrillation – AF, diabetes mellitus – DM, chronic kidney disease – CKD), and laboratory parameters.
Results. The average age of patients was 63.5±14.4 years, 70.4% of them were men, among whom the majority were overweight and obese (75%). The most frequent modifiable risk factors were physical inactivity (82.4%), alcohol consumption (27.1%), and smoking (20.9%). In the comorbidity structure, arterial hypertension (69.6%), CHF (38.1%), DM (33.8%), AF (29.6%), and CKD (26.5%) were the most common. The mean estimated glomerular filtration rate (eGFR) was 56.2±26.5 mL/min/1.73 m². Two or more diseases from the studied continuum (CHF, DM, AF, CKD) were present in 38.3% of patients. The most frequent paired association was the combination of CHF and AF (21.2%). Furthermore, patients with CHF had a significantly higher prevalence of either type 2 diabetes (DM2) or CKD. At the same time, all four conditions (CHF, DM, AF, and CKD) were simultaneously identified in 4.4% of the examined patients.
Conclusion. A high burden of cardiorenal-metabolic multimorbidity was identified in hospitalized cardiac patients: more than a third of those examined (38.3%) were diagnosed with two or more key diseases (CHF, DM, AF, CKD), forming a vicious circle of mutual aggravation.

Objective. To analyze the long-term results in patients with hydrocele after using an improved sclerotherapy technique, and compare them with the results obtained using standard and traditional methods.
Materials and Methods. A study was conducted between 2008 and 2015 based on examination and treatment data from 117 patients diagnosed with hydrocele.
Results. Postoperative scrotal infiltrate observed after 2 months or more developed in 28 patients (48.3%) after the traditional technique but was not observed in any patient after sclerotherapy. Spermatic cord infiltrate was observed in 2 patients (4.1%) after sclerotherapy using the improved technique, in 2 patients (4.0%) after the standard technique, and in 5 patients (8.6%) after the traditional technique. Recurrent hydrocele was detected in one patient (2.1%) after sclerotherapy using the improved technique, in 7 patients (31.8%) after the standard technique, and in 2 patients (3.4%) after the traditional technique. Six to 12 months after surgery, a follow-up ultrasound examination revealed that the volume of the testicle with hydrocele had decreased to 20.9±1.5 cm³, compared to 25.2±2.2 cm³ before surgery. On the healthy side, the volume remained at 20.5±1.3 cm³. The difference between the values before and after sclerotherapy was statistically significant (p<0.05). The average sperm concentration was within the normal range (20.2±4.4 million/ml) in patients of all ages. There were no significant changes in this value during the postoperative period (21.2±3.4 million/ml).
Conclusion. The surgical method has had a significant impact on the long-term outcomes of hydrocele treatment. Patients who underwent sclerotherapy using the improved technique demonstrated good and satisfactory results. These data confirm the high efficacy and minimal trauma of this method.

Objective. To study the pathohistological changes in the mucous membrane of the maxillary sinus in chronic odontogenic perforated maxillary sinusitis and to develop optimal methods for their surgical treatment.
Material and Methods. The study was based on the results of a histological analysis of 33 patients diagnosed with chronic odontogenic perforated maxillary sinusitis. These patients were treated in the Maxillofacial Surgery Department of the National Medical Center of the Republic of Tajikistan “Shifobakhsh” between 2019 and 2024. The patients ranged in age from 20 to 60 years. Of these, 14 were men (42.4%) and 19 were women (57.6%).
Results. Microscopic analysis of the maxillary sinus mucosa revealed the following changes in histological specimens: the specimens were uniformly colored, with interfibrous edema and dystrophic and necrobiotic processes. This resulted in tissue thickening and the appearance of areas of hemorrhagic inflammation. In some areas, foci of necrosis were observed among the inflammatory infiltrates. The infiltrate consists of lympholeukocyte cells with an admixture of neutrophils. The mucosa is atrophic, with destruction of individual areas. Foci of stratified columnar ciliated epithelium are detected, and the vessels are dilated. Disruption of the structure of the inner lining of the vessels—the endothelium—is observed, with the walls of some vessels thickened and fibrous connective tissue proliferation due to sclerosis.
Conclusion. A histological examination of the mucous membrane of the affected maxillary sinus, taken during an intraoperative biopsy, revealed all the hallmarks of a chronic inflammatory process: thickening of the epithelial layer with areas of epithelial desquamation, ulcers, necrotic changes, microabscesses, deep crypts in the epithelium filled with mucopurulent fluid, numerous polypous growths, and areas of remodeling of the ciliated epithelium into pseudostratified squamous epithelium.

Objective. To analyze the clinical manifestations of vertebrobasilar insufficiency in middle-aged and elderly patients.
Materials and Methods. The study was conducted using clinical examination data from 55 patients with a confirmed diagnosis of vertebrobasilar insufficiency. The majority of the patients were men (29 patients, or 52.7%), while women accounted for 26 (47.3%). The patients were middle-aged (45–59 years) and elderly (60–74 years), accounting for 51.0% and 49.0%, respectively.
Results. The study revealed gender differences in disease duration: in men, the average disease duration was 8.42 years, with a maximum of 17 years, indicating significant variability in this indicator within the male subgroup. In the female cohort, the range of values was slightly lower (7.45 years and 15 years, respectively) compared to the male group. Among the most common clinical manifestations in patients with vertebrobasilar insufficiency are: arterial hypertension (in 20 cases, 36.4%), headaches (in 20 cases, 36.4%), dizziness (in 19 cases, 34.5%), general weakness (in 19 cases, 34.5%) and pain in the cervical spine (in 11 cases, 20.0%).
Conclusion. The clinical profile of cerebrovascular diseases is highly variable, ranging from transient, nonspecific symptoms to severe ischemic strokes associated with a high risk of disability and death. The findings indicate a tendency for the disease to progress more slowly in men, which may reflect differences in clinical onset, time to seeking medical care, or progression of the pathological process. These significant differences require further analysis, taking into account clinical, demographic, and socioeconomic factors.

Objective. To study current data on the morphological and clinical properties of bifidobacteria. To evaluate their role in the formation of the intestinal barrier, immune response, and maintenance of metabolic balance.
Materials and Methods. This article analyzes current methods of personalized therapy using bifidobacteria. Particular attention is paid to the clinical significance of these bacteria, the potential use of probiotics, synbiotics, and postbiotics, as well as their role in the prevention and treatment of diseases in gastroenterology, hematology, and oncology.
Results. Bifidobacteria possess unique morphological and physiological characteristics that determine their important role in maintaining human health. They are capable of fermenting carbohydrates, synthesizing short-chain fatty acids and vitamins, and forming stable biofilms, making them an important part of the normal microbiota. Bifidobacteria are essential immunomodulators, ensuring harmonious interaction between various components of the immune system. Bifidobacteria also perform a protective function, strengthening the intestinal barrier and preventing the development of infectious and inflammatory processes. Despite significant advances in knowledge, unresolved issues remain related to optimizing dosages, selecting microbial strains, and determining the optimal timing of their use in clinical practice. The development of personalized medicine, the use of synbiotics and postbiotics, and the integration of probiotic therapy into the comprehensive treatment of serious diseases are also key areas.
Conclusion. Bifidobacteria are key members of the intestinal microbiota, performing a wide range of functions, from metabolic and trophic to immunomodulatory and barrier functions. Modern scientific research highlights their important role in the prevention and treatment of various diseases, including allergic, inflammatory, metabolic, and hematologic oncology.

Objective. To analyze and evaluate the effect of ferazone on structural changes in the liver, spleen and kidneys in toxic liver damage.
Materials and Methods. The study was conducted on 149 albino laboratory rats weighing 210–220 grams. For pathological analysis, the animals’ liver tissue was exposed to the hepatotoxic substance CCL4 (carbon tetrachloride, or tetrachloromethane). The micropreparation “Ferazon” was administered to the rats intragastrically via gavage at a dose of 0.5 mg/kg.
Results. After administration of ferazone at a dose of 0.5 mg/kg to animals exposed to CCL4, a pathomorphological examination of the liver showed partial restoration of the beam and lobular structure (regeneration). The tissues showed no foci of necrotic or degenerative changes in hepatocytes; instead, regenerative processes were detected. Glomeruli and nephron capsules, evenly distributed, were clearly visible in the kidney tissue. Epithelial cells of the convoluted tubules of the cortex were arranged in a single layer. In some areas, foci of cell proliferation were observed. In the medulla, the lumens of many tubules were empty, and their epithelium was virtually unchanged. Moderate lymphohistiocytic infiltration was present. Histological changes in the spleen tissue indicate restoration of lymphoid follicle structure due to proliferative changes, the absence of perivascular infiltrates, dilation of the venous sinus, and fragmentation of lymphoid follicles.
Conclusion. The combined administration of ferazon and carbon tetrachloride causes structural changes in the liver, spleen, and kidneys, leading to pronounced degenerative and necrotic processes. However, animals that were administered ferazon after exposure to carbon tetrachloride demonstrated regenerative processes of cellular restoration in these organs. Based on these results, it can be concluded that ferazon has a pronounced hepatoprotective (protective) and regenerative effect.

Objective. To conduct a comparative analysis of the macroscopic characteristics of the placenta in preeclampsia and in physiological pregnancy.
Materials and Methods. The study was conducted using placental samples received by the pathology department of the National Medical Center of the Republic of Tajikistan in Dushanbe during 2025. Based on clinical data analysis from pregnancy records, 20 placentas were selected. These placentas were divided into two groups: the first group included 10 women with preeclampsia, and the second group consisted of 10 women with normal pregnancies.
Results. The average age of women with preeclampsia during pregnancy was 1.5 times higher than that of women in the group with physiological pregnancy: 29.7±12.3 years versus 19.9±5.4 years. Women with preeclampsia were six times more likely to be obese, and delivery was operative and premature in half of the cases (n=50). Newborns of women with preeclampsia had lower birth weight (2700±160 g versus 3600±180 g) and lower Apgar scores (7-8 versus 9-10). The average placental weight in women with preeclampsia was lower (400.92±280.5 g vs. 497.8±120.6 g) compared to women with normal pregnancies. The fetoplacental index was higher in these women (7.0) than in healthy women (5.3). The umbilical cord most often attaches marginally, and a ridge or rim forms on the baby’s placental surface.
Conclusion. Preeclampsia is more common in older pregnant women and those with stage II or III obesity. Preterm labor with early surgical delivery is more often performed in cases of severe preeclampsia. This condition is characterized by decreased birth weight in newborns, as well as a decrease in the weight and size of the placenta.

Objective. To study the wound-healing and antimicrobial properties of lipovitol, carviol, and limonol ointments in experiments on white rats.
Materials and Methods. To study the wound-healing properties and antimicrobial efficacy of 2% and 3% lipovitol, carviol, and limonol ointments, experiments were conducted under vivarium conditions.
Results. The wound area in the series treated with 2% and 3% lipovitol and carviol ointments significantly decreased compared to the initial state. On the third day, the reduction was 22.5%, 25%, 20%, and 23.5%, respectively. By the seventh day, wounds had decreased by 66%, 72.5%, 65%, and 67.5%. On the fourteenth day, in rats treated with 2% lipovitol and carviol ointments, wounds had shrunk to 98.5% and 94% of their initial size. Complete healing was observed with the 3% ointments. The study results showed that 3% lipovitol, carviol, and limoneneol ointments effectively relieve inflammation (reduce exudation, hyperemia, and swelling) by the ninth day. By the tenth to eleventh day, the wounds begin to fill with granulation tissue. Complete healing occurred by the twelfth day in the groups using 3% ointments and by the fourteenth day in the Levomekol group. The ointments have proven effective against a variety of bacteria. They inhibited the growth of Staphylococcus aureus over an area of 30.0 to 36.0 mm, Escherichia coli over an area of 21.2 to 24 mm, Bacillus subtilis over an area of 20.1 to 24.0 mm, Staphylococcus albus over an area of 18.2 to 32.0 mm, and Pseudomonas aeruginosa over an area of 17.2 to 19.0 mm.
Conclusion. Experimental studies have shown that 2% and 3% ointments based on essential oils, such as lipovitol, carviol, and limoneneol, have pronounced wound-healing and antimicrobial properties. This is likely due to their antioxidant, membrane-stabilizing, and anti-inflammatory effects.

Objective. To study the features of clinical, laboratory and instrumental methods for examining inguinal hernias (IH) in patients with benign prostatic hyperplasia (BPH).
Materials and Methods. The study is based on the treatment and examination results of 80 patients with IH and BPH admitted to the surgery and urology departments of the Dushanbe City Emergency Medical Center between 2010 and 2025. The diagnostic algorithm included clinical examination, prostate-specific antigen (PSA) levels, and imaging studies.
Results. A study of PG in patients with BPH revealed that lower urinary tract symptoms (LUTS) have low specificity for bladder outlet obstruction (BOI) and, therefore, cannot be considered a reliable diagnostic criterion. To improve the accuracy of diagnosing BIO, a number of ultrasound parameters were proposed. Analysis of PSA level distribution among patients in the main group with BPH revealed a clear correlation between PSA levels and the severity of hyperplasia. Interpretation of ultrasound results in patients with PG included analysis of both indirect signs and absolute ultrasound findings, which confirmed small bowel loop strangulation with a diagnostic accuracy of 78–80%.
Conclusion. In patients with PG associated with BPH, clinical, laboratory, and instrumental diagnostic methods require a comprehensive and differentiated approach, taking into account functional disorders of the lower urinary tract. Optimization of the diagnostic algorithm allows for informed selection of surgical tactics and improved treatment outcomes for this category of patients.

Objective. To analyze conservative and surgical methods for treating echinococcosis of the liver and abdominal organs, optimize indications for surgery, develop protocols for bed treatment, and evaluate the effectiveness of available germicides.
Materials and Methods. This literature review summarizes publications by Russian and international researchers from 2016 to 2024 on one of the key topics in modern abdominal surgery: echinococcosis of the liver and other abdominal organs. Particular attention is paid to controversial aspects of surgical treatment tactics and technology for liver damage.
Results. Alongside traditional surgical treatments for liver echinococcosis, endovideosurgical and other minimally invasive approaches continue to develop rapidly. However, no consistent trend toward a reduction in recurrence rates has been observed. To improve short- and long-term outcomes, puncture and puncture-drainage techniques, percutaneous interventions, and laparoscopic technologies have been actively implemented, which are particularly important for severe forms of parasitic pathology. The limited success rate is attributed to the lack of a generally accepted algorithm for selecting a surgical procedure that takes into account key process characteristics: cyst size and topography, fibrous capsule thickness, and parasite morphological features. Further complications are created by the variability of cyst bed treatment techniques and the extremely limited range of truly effective germicidal solutions. All of this contributes to the heterogeneity of treatment practices and hinders standardization.
Conclusion. The spectrum of conservative and surgical approaches to treating echinococcosis of the liver and abdominal organs covers the entire spectrum, from minimally invasive interventions to traditional surgeries. However, a need has been identified for the development of unified diagnostic and surgical standards. Further research, refinement of existing approaches, and personalization of treatment decisions are needed.

Objective. To analyze current scientific data on the pathogenesis, clinical manifestations, and evidence-based treatment methods for hypertrophic and keloid scars. We also aim to identify risk factors for their development and identify prevention strategies.
Materials and Methods. An analytical review of publications from recent decades was conducted, including data from clinical, histopathological, and experimental studies. The mechanisms of inflammation in the reticular dermis were examined, the factors contributing to pathological scarring were analyzed, and the effectiveness of various treatment methods, including conservative, physical, injection, surgical, and adjuvant approaches, was assessed based on data from meta-analyses and large clinical reviews.
Results. Long-term inflammation plays a key role in the formation of keloids. Hypertrophic scars, on the other hand, are characterized by transient inflammation and do not extend beyond the original wound. Keloids are characterized by increased expression of collagen types I and III, the presence of hyalinized collagen fibers, and two growth phenotypes. Silicone sheeting, corticosteroid injections, and their combination with 5-fluorouracil and laser therapy are recognized as the most effective treatment methods. Surgical excision is effective only with mandatory adjuvant therapy, including low-dose radiotherapy, enzyme therapy, and laser therapy. Prevention is aimed at accelerating epithelialization, reducing mechanical tension, and ensuring long-term stabilization of the immature scar.
Conclusion. Pathological scars arise from chronic inflammation and the effects of various external and internal factors. The optimal treatment strategy should be individualized and comprehensive, with an emphasis on reducing inflammation and preventing recurrence. Cellular technologies remain a promising area that requires further research.

Objective. To analyze current data on the effectiveness of traditional and innovative treatments for urethral strictures. To evaluate the role of adjuvant therapy and the potential for implementing telemedicine and telementoring technologies. To compare the findings with existing clinical guidelines.
Materials and Methods. To prepare this review, a systematic search of the scientific literature was conducted for the period from 2000 to 2025. The study utilized PubMed, Web of Science, and Scopus databases. The sample included English-language publications, as well as selected Russian-language materials that met the required reliability criteria.
Results. The development and standardization of modern urethroplasty techniques, including tunnel urethroplasty, transurethral dorsal and ventral urethroplasty, and glans-preserving augmentation, contribute to achieving high functional and aesthetic results in the treatment of urethral diseases. The introduction of modern minimally invasive technologies, such as Optilume drug-eluting balloon dilation, has significantly reduced the recurrence rate and improved the quality of life for patients suffering from recurrent strictures. The development and use of postoperative adjuvant pharmacotherapy, including mitomycin C and steroids, as well as new drug delivery systems (hydrogels, biodegradable stents), are aimed at suppressing fibrosis and improving treatment outcomes in the postoperative period. Strengthening mentoring programs using modern telecommunications technologies, such as telemedicine and telementoring, contributes to improving surgical skills and the sustainability of healthcare systems in resource-limited countries.
Conclusion. In modern urology, reconstructive treatments for urethral strictures are considered the most reliable and effective, especially for extended lesions, recurrent stenosis, and after unsuccessful endoscopic interventions. Selecting the optimal technique requires a thorough analysis of the anatomical features of the lesion, taking into account previous surgical interventions and comorbidities.

Objective. To summarize the current capabilities and prospects for the use of laser surgery to improve visual function in patients with myopia and myopic astigmatism.
Materials and Methods. This review article is based on a systematic search and analysis of current domestic and international publications devoted to laser refractive surgery for myopia and myopic astigmatism.
Results. In recent decades, laser refractive surgery has seen a steady increase in the use of visual correction methods for patients with myopia and myopic astigmatism. Among modern photorefractive technologies, LASIK, PRK, and SMILE have the greatest clinical significance. Long-term research confirms the high efficacy and safety of these procedures for myopia and myopic astigmatism, especially with moderate to severe refractive errors. SMILE is characterized by less invasiveness, a reduced risk of dry eye syndrome, and stable visual outcomes in the late postoperative period. LASIK remains the most widely used method due to its predictable results and short recovery period. PRK remains relevant in cases of insufficient corneal thickness or contraindications to other methods. The importance of an individualized approach when choosing a correction method is also noted, based on the anatomical and functional characteristics of the eye, the patient’s age, the degree of ametropia, and the expected outcome of the procedure.
Conclusion. The review emphasizes the importance of surgical correction of myopia and myopic astigmatism using modern capabilities and the effectiveness of laser surgery (LASIK, FS-LASIK, PRK, SMILE), as well as reducing the incidence of complications and improving the quality of life of patients with this pathology.

Objective. To analyze the etiologic factors influencing the development of urethral strictures.
Materials and Methods. A search and analysis of the most significant publications, selected according to their relevance criteria, was conducted from scientific studies available in the PubMed, Scopus and eLIBRARY databases.
Results. An analysis of the etiologic factors contributing to the development of urethral strictures revealed the most common causes: iatrogenic injuries caused by transurethral resection and catheterization, trauma from pelvic fractures, and complications following hypospadias repair and radical prostatectomy. Cases caused by idiopathic diseases and infectious urethritis were also identified. The distribution of causes of urethral strictures varied significantly depending on the level of economic development of countries. In developed countries, the main factors leading to strictures were iatrogenic and idiopathic causes. Meanwhile, in developing countries, infectious urethritis was the most common. Iatrogenic injuries significantly worsen the results of repeat surgeries. Each subsequent surgery reduces the success rate by 50%. The development of minimally invasive technologies for the treatment of prostate pathologies has led to an increase in the incidence of iatrogenic urethral injuries, which, in turn, leads to trauma and the development of urethral strictures.
Conclusion. Determining the etiology of urethral strictures serves as the basis for developing effective preventive measures and treatment strategies. This helps minimize disease-related risks, improve treatment outcomes, and optimize healthcare costs.

Objective. This review systematizes modern data on pathophysiological mechanisms, as well as the role of classical and new biomarkers in diagnosis, risk stratification and outcome prediction in cardiorenal syndrome.
Materials and Methods. The literature search included PubMed, MEDLINE, Scopus, Web of Science, CyberLeninka, and ELIBRARY.
Results. Cardiorenal syndrome is a pathophysiological condition characterized by acute or chronic dysfunction of the heart and kidneys. This condition is associated with an increased risk of hospitalization and mortality. Combined cardiovascular and renal dysfunction is a serious medical and social problem. It is characterized by difficulties in diagnosis, treatment selection, and a poor prognosis for patients. Hemodynamic disturbances, excessive activation of the neurohormonal system, endothelial dysfunction, oxidative stress, and chronic inflammation play a key role in the development of cardiorenal syndrome. These factors form a vicious cycle that exacerbates damage to both organs.
Conclusion. An analysis of the current literature reveals the complex and multifaceted pathophysiological mechanisms underlying cardiorenal syndrome and convincingly demonstrates the significant potential of modern biomarkers in developing treatment strategies for this condition. The use of accurate, reproducible, and clinically validated markers can significantly improve the effectiveness of cardiovascular disease prevention, enable dynamic patient monitoring, and facilitate the early detection of complications.

Objective. To analyze current trends in the prevalence of urethral stricture at the global level, including the incidence of the disease, regional characteristics, the influence of age, social and etiological factors.
Materials and Methods. To analyze the current characteristics of urethral stricture, a comprehensive analysis of data on its prevalence, incidence, and epidemiological characteristics was conducted. The study included data from published clinical reviews, specialized urology centers, multicenter analyses, and national registries.
Results. Epidemiological and socioeconomic analysis of urethral stricture demonstrates that this condition remains a pressing issue for global urological practice. Systematic studies of prevalence, incidence, and etiologic factors, as well as an understanding of regional characteristics and demographic differences, enable the development of preventive strategies, reducing incidence, and ensuring patients’ access to high-quality and timely medical care.
Conclusion. Current epidemiological data allow us to objectively assess the incidence of urethral stricture in different countries and identify differences between developed and developing regions. The heterogeneity of etiologic factors and age-related characteristics indicates the need for further multicenter studies. This will allow us to refine preventive measures, improve the quality of medical care, and develop the most effective treatment approaches.

This article presents the clinical case of patient Sh.M. (35 years old), who was diagnosed with a giant ureteral stone. A urinary tract ultrasound revealed left-sided hydronephrosis and a hyperechoic lesion in the middle and lower portions of the left ureter. A plain urogram (urogram) of the urinary system revealed a giant stone in the middle and lower third of the left ureter. It is 16.8 cm long and weighs 86 grams. A left-sided ureterolithotomy (11 cm) was performed above the stone, followed by drainage of the left kidney via a ureterostomy. The postoperative period was uneventful.