Vol 7, №2

Objective. To analyze the features of the nosological structure of chronic kidney disease (CKD) at different stages of specialized medical care depending on the profile of medical institutions.

Materials and Methods. The study analyzed data from 2020 to 2025. During this time, 14114 patients with CKD stages C1–C5 received inpatient treatment in eight nephrology departments in the Republic of Tajikistan. Data on 6532 patients with end-stage CKD (C5D) who underwent programmatic hemodialysis in 15 specialized centers and departments were also reviewed. During the analyzed period, 929 kidney transplants were performed in the country. Data on 895 patients followed up after transplantation were also analyzed.

Results. In hemodialysis centers and departments, the main causes of CKD were chronic glomerulonephritis and diabetic nephropathy. The share of chronic glomerulonephritis decreased from 52.6% in 2020 to 45.7% in 2025, while diabetic nephropathy increased from 24.6% to 37.4%. In 2025, hypertensive nephropathy accounted for 14.6%. Changes were also observed in nephrology departments: the share of chronic glomerulonephritis decreased from 32.1% to 27.0%, and chronic pyelonephritis/tubulointerstitial nephritis from 26.6% to 20.1%. At the same time, diabetic nephropathy increased from 20.9% to 26.0%. The incidence of autosomal dominant polycystic kidney disease increased from 2.6% to 7.4%. The pattern of diseases in patients after kidney transplantation remained stable (p=0.720; Cramer’s V=0.087). In this cohort, the leading causes of CKD were chronic glomerulonephritis (40.5–51.8%) and hypertensive nephropathy (19.8–21.6%).

Conclusion. The study results can be used to improve patient care for CKD and more accurately plan nephrology care, taking into account the profile of medical facilities, stage, and disease structure.

Objective. To study the prevalence and clinico-demographic features of different phenotypes of chronic heart failure (CHF) in hospitalized patients with chronic kidney disease (CKD).

Materials and Methods. A retrospective study included 396 patients with CHF and CKD, confirmed by reduced glomerular filtration rate (GFR <60 ml/min/1.73 m²). According to left ventricular ejection fraction (LVEF), patients were divided into three phenotypes: CHF with preserved LVEF (CHFpEF, ≥50%), mid-range LVEF (CHFmrEF, 40–49%), and reduced LVEF (CHFrEF, <40%).

Results. In CKD stage 5, CHFpEF predominated – 72.0% versus 47.3% in CKD stages 3–4 (p<0.001), whereas in CKD stages 3–4 CHFrEF was more frequent – 40.1% versus 21.5% (p<0.001). Trend analysis (p-trend) revealed a statistically significant decrease in age, obesity, type 2 diabetes mellitus, atrial fibrillation, and E/e’ ratio when moving from CHFpEF to CHFrEF (p-trend<0.05), as well as a significant increase in the proportion of men, prevalence of ischemic heart disease, NT-proBNP level, left atrial volume index, and sodium level (p-trend<0.05). Myocardial hypertrophy was pronounced in all CHF phenotypes and did not show a statistically significant trend (p-trend=0.124).

Conclusion. The phenotype of CHF in patients with CKD determines a specific clinico-demographic profile characterized by distinct linear trends across most parameters. The predominance of CHFpEF at the terminal stage of CKD and the identified structural and functional myocardial differences highlight the need for a differentiated approach to the management of this patient population.

Objective. To assess the state of humoral immunity (levels of IgA, IgM, IgE, total IgG, as well as subclasses IgG1, IgG2, IgG3 and IgG4) in children with newly diagnosed acute leukemia before the start of specific antitumor treatment in the population of the Republic of Tajikistan.

Materials and Methods. A prospective cohort study was conducted involving 60 patients aged 1 to 15 years (median age 6.5 years) newly diagnosed with acute leukemia: 42 children with acute lymphoblastic leukemia (ALL) and 18 with acute myeloid leukemia (AML). The control group consisted of 30 healthy children of the same age and gender. Blood samples were collected before induction chemotherapy. Concentrations of immunoglobulins of the IgA, IgM, IgG classes, as well as IgG1–4 subclasses, were determined by chemiluminescence immunoassay.

Results. In patients of the main group, a statistically significant decrease in the levels of IgA, IgM, total IgG and subclasses IgG1 and IgG2 was found compared with the control group (p<0.05). The levels of IgE and IgG4 did not differ between the groups (p>0.05). Partial deficiency of IgG2 (<1.5 g/L) was detected in 20% of children with acute leukemia and was associated with a history of recurrent bacterial infections (χ² = 4.89; p = 0.027). In girls, the levels of IgM and IgG2 were statistically significantly lower than in boys (p<0.05). The maximum decrease in humoral parameters, especially IgG2, was observed in children under 5 years of age.

Conclusion. Children with newly diagnosed acute leukemia experience a significant humoral immune deficiency during the pre-treatment phase, primarily due to decreased levels of IgA, IgM, and IgG1–IgG2 subclasses. Partial IgG2 deficiency is detected in one in five patients, significantly increasing the risk of infectious complications. Therefore, routine IgG subclass determination is recommended during the initial examination, and immunoglobulin replacement therapy should be considered for IgG2 levels <1.5 g/L.

Objective. To analyze long-term outcomes, the structure of causes of mortality, and identify independent predictors of overall mortality in patients with chronic kidney disease (CKD) depending on the stage of the disease.

Materials and Methods. A total of 847 patients with CKD were included in this retrospective-prospective study. Of these, 483 were at stages C3–C4, and 364 were at stage C5. The follow-up period was 2 years. The transition to renal replacement therapy, all-cause mortality, and causes of death were assessed. Survival was calculated using the Kaplan–Meier method and the log-rank test. The Cox proportional hazards model was used to identify independent predictors.

Results. In the C3–C4 group, 73.1% of patients retained kidney function without the need for renal replacement therapy, while the mortality rate was 10.8%. In the C5 group, 45.9% of patients were transferred to dialysis, and the mortality rate reached 22.8% (p<0.001). Cardiovascular events remained the leading cause of death in all groups: their share was 53.8% in the C3–C4 group and 65.1% in the C5 group. Two-year survival was significantly higher in the C3–C4 group (89.2%) compared to the C5 group (77.2%; p<0.001). Among patients in the C5 group, survival at 2 years was significantly higher in those who started hemodialysis compared to patients on conservative therapy: 81.8% versus 62.3%, respectively (p=0.003). The Cox model identified six independent risk factors for all-cause mortality: age over 65 years (HR = 2.0); chronic heart failure (HR = 2.4); serum albumin level less than 35 g/L (HR = 2.2); poor treatment adherence (HR = 1.9); type 2 diabetes mellitus (HR = 1.8); elevated serum phosphate level (more than 1.8 mmol/L, HR = 1.6).

Conclusion. The stage of chronic kidney disease is an independent predictor of prognosis. Mortality is primarily determined by cardiovascular and infectious complications, with the contribution of cardiovascular pathology increasing as the disease progresses. Timely transition to hemodialysis in end-stage CKD improves survival. Modifiable risk factors include poor treatment adherence, hypoalbuminemia, and hyperphosphatemia.

Objective. Development and improvement of diagnostic methods, increasing the effectiveness of surgical treatment of suppurating echinococcosis of the brain.

Materials and Methods. An analysis of data from 9 patients (4 of whom were children, or 44.4%) with suppurative echinococcosis of the brain was conducted. The patients’ ages ranged from 6 to 66 years. All of them were treated at the Department of Neurosurgery and Combined Trauma of the Avicenna Tajik State Medical University between 1995 and 2026. Among the patients, there were 6 men (66.7%) and 3 women (33.3%). The average age of children was 11.0 ± 5.23 years, and that of adults was 34.2 ± 19.24 years.

Results. Patients were admitted to the clinic at various stages of the disease: subcompensation (2 patients), moderate decompensation (5 patients), and severe decompensation (2 patients). Disease duration ranged from 2 weeks to 2 years. The clinical presentation of suppurative echinococcosis of the brain was characterized by pronounced cerebral hypertensive symptoms (100% of cases) and focal neurological impairment (88.9% of cases). All patients experienced epileptic seizures. The parasitic cyst diameter ranged from 2.5 to 10.0 cm. The diagnostic efficiency of computed tomography and magnetic resonance imaging was 97-100%. Postoperatively, 6 patients (66.7%) experienced regression of neurological symptoms, with one patient (11.1%) experiencing partial regression. One patient’s condition remained severe without regression of neurological deficit and was transferred to the neurology department for further therapy. One patient died. The average length of inpatient treatment was 25.7±4.4 days.

Conclusion. The prolonged asymptomatic course of suppurative echinococcosis of the brain leads to delayed presentation to a doctor – especially with large cysts and in the moderate to severe decompensation phase. The use of improved diagnostic methods in combination with comprehensive treatment significantly improves treatment outcomes.

Objective. To study the prevalence of oncogenic human papillomavirus (HPV) genotypes among patients with invasive cervical cancer (CC) using data from the Republican Oncology Research Center (RORC) of Tajikistan.

Materials and Methods. A statistical analysis of HPV tests was conducted among patients treated at the RORC in 2025 and 2026. A total of 117 women participated in the study. The DNA-sorb-AM DNA extraction kit was used to detect and measure high-risk HPV DNA.

Results. Among 117 patients with cervical cancer, HPV type 16 (1a) was the most common – it was detected in 85 cases (72.6%). The second most common were HPV types 18 and 45 (1b), each of which was detected in 6 cases (5.1%). HPV subgroups 1a and 1b together accounted for 82.8% of all observations. In the remaining 17.2% of cases, HPV 1c was detected in 4.3%, and HPV group 2 also in 4.3%. The virus was not detected in 8.6% of cases. In 87 cases (74.4%), one HPV type was detected, in 20 cases (17.1%) – two or three viruses. According to the histological type, squamous cell carcinoma was diagnosed in 112 cases (94.9%), and adenocarcinoma of the cervix was diagnosed in 6 cases (5.1%). Among the causes of adenocarcinoma, HPV type 16 was identified in four cases, HPV type 18 in one case, and HPV types 16 and 58 in another.

Conclusion. A single HPV test in patients with invasive cervical cancer detected carcinogenic HPV types in 91.4% of samples. This result confirms the high sensitivity of virological diagnostics for this pathology. Among the oncogenic genotypes, HPV types 16, 18, and 45 were the most common. Testing for carcinogenic HPV types is essential for implementing primary prevention measures and improving approaches to cervical cancer treatment in the republic.

Objective. Analyze data from a pilot implementation of screening for noncommunicable diseases (NCDs). This will help identify factors that contribute to the successful integration of the program into primary health care and its sustainable development.

Materials and Methods. Four geographic districts were selected for the NCD screening pilot program: Rudaki District and Tursunzade City (both Districts of Republican Subordination), as well as Levakant City and Kushoniyon District (both in Khatlon Region). Screening was implemented in eight rural health centers (RHCs) in the pilot districts: Pakhtaobod, Batosh, Sarikishtii Poyon, Chorteppa, Boturobod, Kuli Sufiyon, Voroshilov, and Bustonkala. Screening was conducted from 2023 to 2025.

Results. The screening covered 14,632 people, representing 70.2% of the target group—the population aged 40 and over. NCD screening coverage varied significantly across the eight pilot RHCs. The highest rates were recorded at Pakhtaobod RHC in Tursunzade (100%) and Kuli Sufiyon RHC in Levakant (96.8%). The lowest coverage rates were observed at Chorteppa RHC in Rudaki District (54.3%), Batosh RHC (56.3%), and Bustonkala RHC in Kushoniyon District (56.9%). High blood pressure was detected in 32.1% (n=2,659) of the surveyed participants. Overweight was detected in 41.3% (n=3,415) of the participants, and obesity in 33.3% (n=2,756). Hypercholesterolemia was recorded in 64.3% (n=5,323), and elevated blood glucose levels in 3.7% (n=303). The proportion of respondents who had never measured their blood pressure, glucose, or cholesterol levels significantly decreased from 32.0% to 6.2%, from 73.0% to 23.3%, and from 80.1% to 33.0%, respectively. An increase in the number of people admitting to being obese was also noted, which almost doubled from 6.8% at the initial stage to 12.1% at the final stage.

Conclusion. The program revealed a significant number of previously undiagnosed cases of hypertension, carbohydrate metabolism disorders, and other risk factors, indicating the hidden burden of noncommunicable diseases. Screening for noncommunicable diseases is essential for its successful implementation in primary care.

Objective. To evaluate the clinical effectiveness of complex treatment of thermal and infected wounds in patients with type II diabetes mellitus, and to determine the prospects for implementing the obtained results into clinical surgical practice.

Materials and Methods. A prospective comparative study of 60 patients with grade II–IIIB burns and infected wounds was conducted. Patients were divided into two groups of 30 patients each. The intervention group received a combination of surgical debridement, negative-pressure vacuum therapy, modern interactive wound dressings, systemic metabolic correction, and low-level laser therapy. The control group received standard treatment: antiseptic dressings and traditional medications.

Results. Patients in the study group showed a significant acceleration of all phases of the wound healing process. The most significant differences concerned the time of wound cleansing (5.1±1.2 days in the study group versus 10.6±2.4 days in the control group) and epithelialization (19.8±3.5 days versus 35.2±5.6 days, respectively). Bacterial contamination in the study group decreased significantly faster than in the control group. The complication rate in the study group was 6.6%, which is approximately 3.5 times lower than in the control group (23.3%). Amputations were recorded exclusively in the control group (3 patients, 10%), while no amputations were observed in the study group. The data obtained demonstrate a statistically significant reduction in the risk of severe outcomes and an increased likelihood of limb salvage with the proposed treatment approach. An assessment of clinical outcomes showed that the average glycemic level in the study group was lower compared to the control group: 7.7±1.5 mmol/L versus 9.8±2.1 mmol/L.

Conclusion. Comprehensive treatment of burns and infected wounds in patients with type II diabetes mellitus allows for improved reparative processes, a reduction in the incidence of infectious complications, and increased effectiveness of surgical treatment.

Objective. To improve treatment outcomes for patients with complex duodenal ulcer complications (DUC). To this end, we plan to implement a pathogenetically based classification, develop algorithms for digital objectification of surgical procedures, and optimize the routing system for the specific geographic conditions of the Republic of Tajikistan.

Materials and Methods. A comprehensive analysis of the results of surgical treatment of 658 patients with SO of the duodenum, as well as epidemiological data on perforated ulcers and acute ulcerative gastroduodenal bleeding in the Republic of Tajikistan over a 35-year period (1988-2023) was conducted.

Results. The examined group of patients was predominantly male (79.2%, ratio 3.8:1). Eighty-one percent of patients had a long history of ulcers, ranging from 5 to 27 years. The predominant variant of DU was found to be a combination of stenosis and penetration (55.9%). Severe three- and four-component complications were recorded in 26.1% of cases. An epidemiological analysis revealed a cyclical pattern of this pathology, with a peak in urgency between 1988 and 1997: 22.4 perforations, 37.6 bleedings, and 4.2 SD per 100,000 population. Thanks to modern treatment protocols and endohemostasis, as well as the widespread use of laparoscopy over the past decade, surgical activity for bleeding has been reduced to 6–12% and postoperative mortality has stabilized: 1.6% for gastroduodenal ulcers and 1.43% for perforations. The strategy is based on the concept of ulcer penetration as a “trigger” for a cascade of complications. To improve the effectiveness of care, a three-tiered routing model has been implemented, ensuring compliance with the “golden hour” rule in mountainous terrain. Digital transformation – mandatory photo and video recording, and the creation of a registry of ulcers in the duodenum – has made it possible to objectify the treatment process and create a basis for remote expert support.

Conclusion. The transition to a new surgical paradigm based on minimally invasive technologies, streamlined logistics, and digital control minimizes tactical and technical errors, ensures legal protection for personnel, and enables the provision of high-tech care at world-class standards, even with limited resources.

Objective. To improve the effectiveness of surgical treatment of severe contractures and deformities of the lower extremities using precision techniques and optical magnification.

Materials and Methods. From 2000 to 2025, 60 patients (36 men and 24 women) underwent various types of local plastic surgery to correct severe deformities and contractures of the lower extremities.

Results. Victims with severe deformities and contractures of the foot and toes sought treatment aged between 6 months and 15 years. Most patients (45) had unilateral limb damage, while 15 (25%) had bilateral damage. The primary cause of deformities in the majority of patients (37) was burns from hot liquids. Severe contractures with loss of toes were found in four patients who had suffered sandal burns in childhood. An evaluation of the immediate results revealed that wound infection developed in three cases, and necrosis of the tips of the excised skin grafts developed in five cases. In one case, total wound suppuration was observed, but repeat correction resulted in a satisfactory outcome. Contracture recurrence occurred in four patients late after surgery. Isolated toe contractures were corrected using Z-plasty in 21 cases. Combined contractures of the toes and ankle were also corrected.

Conclusion. In recent years, there has been an increase in the number of patients with contractures and deformities of the lower extremities. The use of optical magnification, precision technology, and the selection of the optimal surgical technique contribute to achieving satisfactory long-term results. When correcting severe contractures and deformities, a shortage of local grafting material often occurs. Remaining uncovered areas of skin require the use of full-thickness skin grafts.

Objective. To evaluate the clinical effectiveness of By-Pass mini bypass surgery in patients with morbid obesity based on an analysis of body weight changes, body mass index (BMI), and the regression of comorbidities in the postoperative period.

Materials and Methods. The article presents the results of surgical treatment of 55 patients with morbid obesity who were treated in a specialized surgical department from 2021 to 2025. Of the examined patients, 52 were women (94.5%), and 3 were men (5.5%). The age of the patients ranged from 24 to 58 years, the average age was 41.3±6.4 years. Depending on the initial BMI, the patients were divided into three clinical groups: Group I – patients with a BMI of 35-40 kg/m² – 14 patients (25.4%); Group II – patients with a BMI of 41-50 kg/m² – 27 patients (49.1%); and Group III – patients with a BMI of more than 50 kg/m² – 14 patients (25.4%).

Results. Twelve months after the surgery, the average body weight decreased from 136.8±18.2 kg to 84.9±12.5 kg, and the average BMI decreased from 47.2±5.8 kg/m² to 29.7±3.9 kg/m². The most pronounced positive dynamics were observed in patients of Group II. In patients with type 2 diabetes mellitus, 15 (71.4%) patients achieved persistent normalization of blood glucose levels without the need for constant intake of hypoglycemic drugs. The remaining patients experienced a significant reduction in the dosage of drug therapy. Regression of arterial hypertension was observed in 24 (70.6%) patients, a decrease in the manifestations of obstructive sleep apnea syndrome – in 13 (76.5%) patients.

Conclusion. The mini gastric bypass surgery demonstrates high clinical efficacy and can be recommended as one of the leading surgical treatment methods for patients with severe morbid obesity and associated organ and system dysfunction.

Objective. To evaluate the mechanical strength of the developed precision tendon suture and conduct a comparative analysis of its characteristics with traditional methods of applying tendon sutures.

Materials and Methods. Twelve lamb tendons were used in the study. Three different types of tendon sutures were applied: the Bunnell-Cuneo suture, the Rozov-Kessler-Tajima suture, and the proposed suture, which differs in design and the number of fixing knots.

Results. Comparative data on the mechanical strength of the proposed precision tendon suture and the most commonly used traditional techniques were obtained. Postoperative macroscopic analysis allowed us to determine the optimal suture type due to its minimal tissue trauma. The precision tendon suture demonstrated the best mechanical strength. Its average strength was 68.8±7.2 N, significantly exceeding that of traditional sutures. The Bunnel-Cuneo suture demonstrated a strength of 55.5±3.5 N, and the Rozov-Kessler-Tajima suture demonstrated a strength of 27.5±3.0 N. This indicates lower tear resistance compared to the method developed by the authors.

Conclusion. A clinical and experimental study of traction testing revealed that the Bunnell-Cuneo suture was stronger than the Rozov-Kessler-Tajima suture. The authors’ original precision tendon suture demonstrates superior mechanical strength compared to traditional fixation methods. The findings confirm the effectiveness of the proposed technique and its potential for use in reconstructive hand surgery.

Objective. To study the correlation between clinical symptoms in patients with chronic abacterial prostatitis (CAP) associated with herpesvirus infection (HPV).

Materials and Methods. We conducted a retrospective and prospective analysis of data from 61 patients with chronic prostatitis associated with genital herpes (Group 1) and 50 asymptomatic men (Group 2), aged 25 to 50 years. During the initial examination, in addition to signs of chronic prostatitis, we looked for symptoms of herpes infection both at the initial examination and in the patient’s medical history.

Results. In patients with HPV-associated CAP who presented systemic complaints, the median level of HPV was 120.00 [80.25; 233.50] conventional units, while in patients without complaints it was 36.00 [22.25; 53.75] conventional units (p<0.0001). A similar trend was observed for cytomegalovirus and Epstein-Barr virus (p<0.0001). In patients with HPV-associated CAP who presented complaints of local symptoms, the median level of the total number of HPV was also higher – 156.00 [84.50; 350.00], compared to patients without local complaints – 45.00 [25.00; 82.00] (p<0.0001). The association assessment showed that the occurrence of local and general symptoms of the disease was significantly associated with a high probability of high HPV levels [AUC 0.884; odds ratio 25.0; 95% confidence interval: 4.99–125.31; p<0.0001].

Conclusion. A study of prostate secretions using microbial marker mass spectrometry enabled the identification and quantification of herpesvirus levels. The results indicate a possible link between increased levels of herpesviruses types 1 and 2 and clinical manifestations in patients with chronic prostatitis and chronic pelvic pain syndrome.

Objective. To conduct a comparative assessment of nephrectomy indicators taking into account kidney volume, duration of surgery and patient body mass index.

Materials and Methods. The study analyzed data from 803 patients who underwent nephrectomy. The evaluation was conducted taking into account the following parameters: the volume of the removed kidney, the duration of the surgery, and the patients’ body mass index.

Results. The most significant differences were found in patients with a kidney volume of 100 cm³ or more compared to patients with a volume of less than 100 cm³. In patients whose surgery lasted more than 2 hours, there was a significant increase in blood loss by an average of 63.1 ml (1.8 times). For the “duration of surgery” indicator, the difference was an average of 49.9 minutes (р<0.0001), for the “average tumor size” indicator – an average of 1.4 cm (р<0.0001), for CO₂ consumption – an average of 39.8 liters (1.3 times). There was also an increase in the number of complications during surgery by 0.11 (р=0.0002) and after surgery by 0.2 (р=0.0010), as well as the volume of blood transfusion by 0.1 (р=0.0101) and plasma transfusion after surgery by 0.1 (р=0.0022). The indicator “time in intensive care” increased by an average of 3.2 hours (р=0.0133), and the number of bed-days after surgery – by 1.1 bed-days (р<0.0001). In patients with excess body weight, the volume of blood loss was greater than in patients with normal body weight, on average by 33.9 ml (р=0.0006).

Conclusion. Nephrectomy outcomes are dependent on body mass index: overweight patients experience greater blood loss than normal-weight patients. Surgeries lasting longer than two hours typically result in worse outcomes than shorter surgeries. The most significant differences are observed when assessing kidney volume: patients with a kidney volume of 100 cm³ or more experience worse surgical outcomes than those with a kidney volume of less than 100 cm³.

Objective. To evaluate the antimicrobial activity of Nepeta parviflora extracts using the disk diffusion method to determine their inhibitory effect on the growth of various microorganisms.

Materials and Methods. The study examined the antibacterial properties of alcoholic extracts obtained from the aerial parts of the endemic species Nepeta tytthantha Pojark, native to the Republic of Tajikistan. The extracts’ activity was assessed against two Gram-positive and two Gram-negative bacterial species. The extract’s antifungal activity against Candida albicans, one of the most common fungal species in this genus, was also examined. Two dilutions were used: catnip extract in 70% alcohol and catnip extract in 40% alcohol.

Results. A dilution of catnip (Nepeta) with 70% ethanol demonstrated significant antimicrobial activity against all tested microorganisms. Opportunistic bacteria of the genus Staphylococcus aureus and Pseudomonas aeruginosa, common pathogens of nosocomial infections, were found to be the most sensitive to the extracts. The inhibition zone for S. aureus by ethanol extracts obtained from the leaves of this plant was 23.0±0.15 mm, which is comparable to the effectiveness of the antibiotic furadonin (23 mm). Dilutions of Nepeta grandiflora with 40% dry extract showed significant but slightly reduced antimicrobial activity. All extracts demonstrated maximum antibacterial activity against Staphylococcus aureus. Diffusion studies revealed differences in antimicrobial activity between the original powders and the ethanol extract. Among the tested drugs, second- and third-generation cephalosporins and fluoroquinolones (ciprofloxacin, ofloxacin) exhibited the broadest spectrum of antibacterial activity. However, a trend toward decreased susceptibility of gram-negative bacteria (Klebsiella spp., P. aeruginosa) to certain drugs was observed.

Conclusion. Based on the results of susceptibility testing of clinically significant microorganisms to standard antibacterial agents using the disk diffusion method, it was found that the studied microorganisms retain sensitivity to the recommended antibacterial agents.

Objective. To develop and scientifically substantiate the composition and technology for producing hard gelatin capsules based on dried extract of Turkestan hawthorn (Crataegus turkestanica) fruits, and to determine indicators of their quality, stability, and safety.

Materials and Methods. The study examined excipients (aerosil, magnesium stearate, and talc) and assessed their impact on key process parameters: flowability, fluidity, angle of repose, and bulk density. Based on the data obtained, an optimal composition was selected and a capsule production technology was developed under experimental conditions. Hard gelatin capsules of size No. 0 were used for the preparation of the drug.

Results. Using excipients at a concentration of 0.5–1.0% of the total composition weight improves the pharmacotechnological properties. However, using these substances separately does not always ensure optimal results. Composition No. 4—a mixture of three excipients—demonstrates the best solubility and disintegration properties. It has a normal slope of 32.10°, which is lower than other variants and indicates improved powder flowability. The filling density of this composition is 0.68±0.11 g/cm³, which fully complies with technological requirements. Each capsule contains 250 mg of pure extract, and the flavonoid content (calculated as hyperoside) reaches 6.25 mg.

Conclusion. Hard gelatin capsules containing dried Turkestan hawthorn fruit extract meet established requirements. They possess satisfactory technological and pharmaceutical characteristics and offer promising potential for use in medical practice as a herbal medicine.

Objective. To study the efficacy and safety of current antithrombotic strategies, the role of functional assessment and intravascular imaging, and the impact of comorbidity on the outcomes of percutaneous coronary intervention in patients with atrial fibrillation.

Materials and Methods. This review article analyzes the results of randomized clinical trials, systematic literature reviews, and meta-analyses covering randomized and observational studies from 2021 to 2025.

Results. Approximately 20–30% of patients with atrial fibrillation will require percutaneous coronary intervention (PCI) during their lifetime. Of these, approximately 12% already have concomitant atrial fibrillation, which requires long-term oral anticoagulant therapy. The introduction of functional assessment methods (FFR, mFR) and intravascular imaging, along with the development of drug-eluting stents and optimization of antithrombotic therapy, have significantly improved both short-term and long-term outcomes. The transition from triple antithrombotic therapy to a dual strategy, including direct oral anticoagulants and clopidogrel without aspirin, has been one of the major achievements of the last decade. This significantly reduced the risk of bleeding without increasing the risk of thrombotic complications. Key factors determining a favorable outcome include complete revascularization, functionally justified stent selection, the use of intravascular imaging in complex anatomical cases, radial access, and optimal control of comorbid conditions.

Conclusion. The data presented demonstrate significant progress in the field of percutaneous coronary intervention in patients with atrial fibrillation. Atrial fibrillation and coronary artery disease often coexist, especially in elderly patients. This creates a classic therapeutic dilemma: balancing thrombotic risk (stent thrombosis, stroke) with hemorrhagic risk, which inevitably increases with the use of anticoagulants and antiplatelet agents.

Objective. This comprehensive review aims to synthesize the current international evidence and clinical practices regarding the management of fluid collections in acute pancreatitis, with a focus on the paradigm shift from open surgery to a minimally invasive, multidisciplinary step-up approach.

Materials and Methods. An analysis of recent literature (2017-2024) from European, North American, Chinese, Japanese, Russian, and Tajik sources was conducted. The review encompasses data from randomized controlled trials, meta-analyses, cohort studies, and clinical guidelines to evaluate the efficacy, safety, and outcomes of various intervention strategies.

Results. The management of acute pancreatitis complications, particularly infected necrosis and walled-off necrosis, has been revolutionized by the step-up approach. Initial percutaneous catheter drainage serves as a cornerstone for sepsis control. For definitive treatment, endoscopic transmural drainage and necrosectomy, facilitated by lumen-apposing metal stents, and minimally invasive surgical techniques like video-assisted retroperitoneal debridement (VARD) have proven highly effective. Recent comparative trials (eg, MISER, TENSION) demonstrate that although both approaches (endoscopic and surgical) are valid, the endoscopic route may have advantages in reducing the risk of long-term pancreatic failure. The choice of intervention must be tailored to the collection’s anatomy, patient status, and local expertise, often requiring a combined “hybrid” approach.

Conclusion. The correction of pancreatic fluid collections is best managed by a patient-centered, multidisciplinary team. The modern standard of care prioritizes a step-up philosophy, starting with the least invasive procedures. This strategy, supported by robust international evidence, has significantly improved patient outcomes, reducing morbidity, mortality, and the long-term sequelae of necrotizing pancreatitis.