Euroasian Health Journal

Arterial hypertension is one of the leading causes of morbidity and mortality from cardiovascular diseases worldwide, including in the Kyrgyz Republic. One of the most serious complications of this disease is a hypertensive crisis. The urgency of revising current standards is dictated by the continuing practice of overdiagnosis of “uncomplicated” crises, which leads to unnecessary hospitalisations and potentially dangerous aggressive therapy. The purpose was to summarise and present contemporary approaches based on the principles of evidence-based medicine to the definition, classification, diagnosis, and treatment of hypertensive crises to analysis, and adaptation of key clinical guidelines from the European Society of Cardiology, the European Society of Hypertension, the International Society of Hypertension, the British and Irish Hypertension Society, the American College of Cardiology, the American Heart Association, and the Russian Society of Cardiology, published between 2018 and 2025, with particular attention to their applicability in resource-limited settings. The review presented a contemporary clinical definition of hypertensive crises based solely on the presence of acute damage to target organs. The rejection of the term “uncomplicated hypertensive crisis” as an indication for emergency intravenous pressure reduction was substantiated. The algorithm of the initial assessment (identification of “red flags of target organ damage”) was described in detail, and a minimum set of laboratory and instrumental studies was regulated. A differentiated treatment strategy was proposed depending on the type of target organ damage, indicating target blood pressure levels and priority parenteral medications. Special attention was paid to the risks of uncontrolled decrease in blood pressure in inpatient and outpatient settings, and tactics for reducing pressure with an asymptomatic increase. The introduction of uniform standards will reduce inappropriate hospitalisations, improve the safety of treatment, and coordinate tactics at all levels of medical care.

The purpose of the study was to evaluate the prognostic significance of the preoperative volume of peritumoural oedema according to magnetic resonance imaging in patients with gliomas. A single-centre observational study was conducted, including 60 patients aged 21 to 75 years, with predominance of high-grade diffuse gliomas grade 4 according to the World Health Organisation classification. The volume of peritumoural oedema was determined using magnetic resonance imaging in T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences by means of volumetric analysis, followed by stratification into four groups. Neurological, cognitive, and functional status were assessed using the National Institutes of Health Stroke Scale, the Mini- MentalState Examination, and the modified Rankin Scale, with final evaluation performed at 6 months. It was found that the preoperative peritumoural oedema volume significantly correlated with the severity of functional deficiency 6 months after surgery (correlation coefficient r = 0.68; p < 0.001; 95% confidence interval 0.52-0.81). It was shown that with a peritumoural oedema volume of 30 cm3 or more, the proportion of adverse outcomes on the modified Rankin Scale of more than 2 points was 60.0%, whereas with a peritumoural oedema volume of less than 30 cm3, this indicator did not exceed 26.7%. It was calculated that the presence of peritumoural oedema with a volume of 30 cm3 or more is associated with a 4.13-fold increase in the probability of an unfavourable functional outcome (odds ratio 4.13; 95% confidence interval 1.39-12.27; p < 0.01). It was found that after surgical resection, the average volume of peritumoural oedema decreased dynamically, but on the first day there was a temporary increase in oedema followed by regression by days 14-30. A provision has been developed that the quantitative assessment of peritumoural oedema according to preoperative magnetic resonance imaging can be used as an objective criterion for risk stratification and planning decongestant therapy in patients with gliomas

National medical journals play a key role in shaping the scientific agenda, advancing research, and translating scientific evidence into clinical and organisational practice, particularly in the field of maternal and child health. The aim of this study was to synthesise the findings of a bibliometric analysis of the publication activity of the journal “Maternal and Child Health” and to develop recommendations aimed at promoting research in the field of maternal and Child Health. A retrospective bibliometric analysis was conducted of 510 articles published in the journal “Maternal and Child Health” and indexed in the Russian Science Citation Index (RSCI) between 2009 and 2025. An adapted PRISMA flow diagram was used for study selection. A total of 61 journal issues were examined, and citation indicators together with author and institutional profiles were analysed. The findings showed that the journal’s citation impact is primarily driven by publications from its formative years (2009- 2011), predominantly in paediatrics and epidemiology. Of the 510 publications, 140 were authored by a single researcher, while large multicentre research teams were represented only sporadically. The analysis confirmed a high degree of institutional concentration and the predominance of single-author and small collaborative teams, limiting the development of multicentre research. Furthermore, the five most productive authors were affiliated with the journal’s publishing institution, the National Centre for Maternal and Child Health. Recommendations are proposed for the digital transformation of the editorial process, the internationalisation of journal content, and the promotion of interinstitutional collaboration. The findings may be useful for editors and publishers of national medical journals, specialists in bibliometrics, and healthcare administrators seeking to enhance the quality and international visibility of regional scientific journals

Delayed-type metal hypersensitivity, according to the current classification, is classified as subtype IVa. With the introduction of new dental devices, the number of patients with intolerance to metal alloys has increased. The aim of this study was to identify the pathogenesis and clinical manifestations, the main risk factors for the development of delayed-type hypersensitivity to metal structural components, and optimal diagnostic methods in patients in dental practice. A search was conducted on PubMed and e-library (as of February 2026) using the following keywords: adverse effects of dental alloys, skin patch testing, contact allergy to metals, dental materials, allergic reactions, lichenoid reaction. Forty-seven scholarly sources were analysed using bibliographic search, source selection and screening, comparative analysis, and data synthesis. Various diagnostic methods are used to identify these hypersensitivity reactions. A literature review showed that patch testing is the most informative diagnostic method for detecting hypersensitivity reactions to metals used in the fabrication of dental restorations and denture components. They allow for the identification and confirmation of the involvement of a specific causative factor in the development of clinical symptoms in a patient. Delayed-type hypersensitivity is most common to metals such as nickel, cobalt, and chromium. A similar mechanism of hypersensitivity to nickel is recorded in 17% of women and 3% of men, while hypersensitivity to cobalt and chromium is reported in 1-3% of both sexes. An increase in delayed-type hypersensitivity to other metals, such as aluminum, beryllium, copper, gold, iridium, mercury, palladium, platinum, rhodium, and titanium, has also been observed. Patients with immune- mediated pathologies are at high risk for developing delayed-type metal hypersensitivity

Early childhood caries is one of the most prevalent dental conditions affecting young children;however, the lack of up-to-date epidemiological data for Kyrgyzstan hampers the planning of effective preventive measures and the development of targeted preventive programmes. The aim of this study was to investigate the prevalence of early childhood caries among children aged 1-3 years in the city of Bishkek and to identify the key socio behavioural risk factors. A cross-sectional epidemiological study was conducted involving 250 preschool children, of whom 104 met the inclusion criteria and comprised the target subgroup. Dental examinations were performed according to the World Health Organisation diagnostic criteria. Caries status was assessed using the decayed primary teeth index, the number of affected primary tooth surfaces, and the Fedorov-Volodkina oral hygiene index. In addition, parents completed a questionnaire covering oral hygiene practices, dietary habits, and dental attendance. The prevalence of early childhood caries was extremely high, reaching 76.2% among children aged 12-24 months and 91.1% among those aged 25 36 months. Both caries severity and poor oral hygieneincreased with age. The principal risk factors identified were delayed initiation of regular toothbrushing, frequent consumption of sugary foods before bedtime, the absence of preventive dental visits, and limited parental awareness of the role of fluoride and the harmful effects of nocturnal feeding. Early childhood caries represents not only a clinical but also a social problem. Reducing its prevalence requires comprehensive family- centred preventive programmes, including early parental education on oral hygiene practices, the promotion of good oral health habits, and improved access to paediatric dental care. The findings of this study may be used to inform the development of preventive strategies and educational programmes for parents aimed at reducing the prevalence of early childhood caries in young children

Achalasia cardia (AC) is associated with marked impairment of oesophageal food transit and a substantial reduction in quality of life. Despite the widespread use of Heller myotomy, the effect of the type of surgical access on long-term treatment outcomes remains poorly understood. The purpose was to evaluate and compare the five-year results of the Heller myotomy performed by laparoscopic and open access with the analysis of clinical, functional, radiological, and endoscopic parameters. A combined retrospective and prospective multicentre study was conducted, which included 38 patients with confirmed AC. Surgical procedures were performed using open and laparoscopic approaches with antireflux correction. The assessment of efficacy was based on clinical symptoms, radiographic and endoscopic findings, and changes in the symptom severity score. The follow-up period was up to five years. After surgical treatment, there was a statistically significant improvement in all the parameters under study. The severity of symptoms decreased from 8.8 ± 1.5 to 1.7 ± 0.8, the frequency of dysphagia decreased from 100% to 7.9%, and regurgitation decreased from 83.3% to 5.6%. X-ray examination revealed a decrease in the diameter of the oesophagus from 4.8 ± 0.7 to 3.2 ± 0.5 cm and an almost complete elimination of contrast delay. Endoscopic findings confirmed the restoration of cardia patency and a reduction in inflammatory changes of the mucosa. Laparoscopic access demonstrated a more pronounced recovery of evacuation function and a lower incidence of residual disorders compared with open interventions. The results obtained confirmed the high efficiency of Heller myotomy and substantiated the advantage of laparoscopic access in the treatment of AC. The data can be used to optimise surgical tactics and improve the quality of patient treatment, and serve as a basis for further research with sample expansion and standardisation of evaluation criteria.

Emergency abdominal surgery is one of the most rapidly evolving fields of medicine, marked by the active adoption of minimally invasive technologies. Yet the strength of evidence supporting their use across different conditions remains uneven – necessitating systematisation and critical reappraisal of accumulated data, with attention to publications from 2000 to 2025. The aim was to systematise and critically evaluate the evidence from 2000 to 2025 concerning the use of minimally invasive technologies in the most common urgent abdominal conditions, and to identify promising directions for further research. A systematic literature search was conducted in the PubMed, Cochrane Library, Scopus and Web of Science databases for the period 2000-2025. Inclusion criteria covered systematic reviews, meta-analyses and randomised controlled trials. Forty-four sources were included in the analysis. For acute cholecystitis, meta-analyses demonstrated the advantages of early cholecystectomy, reducing hospital stay from 17.8 to 9.6 days with comparable mortality rates. Robot-assisted cholecystectomy reduces the conversion risk by 34% compared with conventional laparoscopy. Ultrasonic dissection shortens operating time by 9 minutes and reduces blood loss by 28 mL. For perforated ulcers, endoscopic techniques reduce respiratory complications by a factor of 2.4, though the methodological quality of the studies remains insufficient. In acute pancreatitis, an endoscopic step-up approach using lumen-apposing metal stents shows the best clinical outcomes. For adhesive small bowel obstruction, five-year follow-up studies found no long-term advantage for laparoscopy. For acute appendicitis, laparoscopic access reduces wound complications by a factor of 2.4, with comparable rates of intra-abdominal abscesses. These findings can help optimise surgical strategy in urgent abdominal conditions, informed by current evidence.

Diseases of the large intestine continue to make a significant contribution to population morbidity and mortality, which determines their high medical and social importance. Since the beginning of the 21st century, an increase in the prevalence of colorectal pathology has been observed, along with a shift in the age structure of patients toward younger groups, which highlights the relevance of analysing factors influencing the development of these diseases and approaches to their prevention. The aim of this review was to summarise and systematise current scientific evidence on risk determinants and strategies for reducing the burden of major diseases of the large intestine. An analysis of 52 publications was conducted, including systematic reviews, meta- analyses, large cohort studies, and randomised controlled trials retrieved from PubMed, Scopus, Web of Science, and Google Scholar databases. The review included studies published between 1990 and 2025, with 53.8% of the sources dated from 2020 to 2025. The literature analysis demonstrated that dietary patterns, excess body weight, low physical activity, smoking, and alcohol consumption play a leading role in the development of large intestinal diseases. Alterations in gut microbiota composition and chronic inflammation are considered key pathogenic mechanisms. A reduction in disease incidence and mortality has been confirmed for screening strategies based on endoscopic and non- invasive methods, as well as for selected pharmacological and technological approaches, including computer- assisted endoscopic systems. The findings of this review may be applied in clinical practice, planning of screening programs, and development of prevention-oriented interventions within public health systems.

Acromegaly is a chronic neuroendocrine disease caused by prolonged hypersecretion of growth hormone and insulin-like growth factor-1 and leading to systemic soft tissue hypertrophy, while the condition of the salivary glands has not been sufficiently explored. The purpose of the study was to compare the size of the submandibular salivary glands according to ultrasound data in patients with active acromegaly and in healthy individuals of comparable age and gender, and to identify clinical and biochemical factors associated with the volume of the glands. A prospective comparative study included 27 patients with active acromegaly and 26 healthy volunteers. All underwent an ultrasound examination of the submandibular glands, measuring the length, width, and thickness of each gland and calculating the volume. The age, duration of symptoms, index of insulin- like growth factor-1, and presence of hyperprolactinaemia and echostructure of parenchyma were additionally assessed in patients. In patients with acromegaly, the median volume of the right gland was higher than in healthy subjects (10.0 versus 6.3 cm3), as was the volume of the left (8.8 versus 7.0 cm3; p < 0.01 for both), with a significant increase in length and width and no differences in thickness. Gland volume was negatively associated with age and duration of symptoms, was higher in men, and tended to decrease in hyperprolactinaemia; male gender, and duration of symptoms turned out to be independent predictors of volume. Acromegaly was accompanied by marked hypertrophy of the submandibular salivary glands, mainly due to an increase in length and width, which allows considering ultrasound evaluation of these glands as an additional non-invasive marker of the tissue response in acromegaly