Vol. 4 No. 4 (2023): VESTNIK of KSMA

The lymphoid apparatus in the walls of different parts of the human stomach is currently insufficiently studied. Features of the localization of immune formations (lymphoid nodules and lymphoid accumulations) in the cardiac, pyloric sections and the fundus of the organ have not been established. The question of the presence of lymphoid nodules with and without germinal centers, as well as lymphoid accumulation in different parts of the stomach, is still being discussed. Their topography, number and dimensions in the walls of the organ in the age aspect have not been established. Their clear histotopography and relation to the glands of the stomach at a relative norm has not been determined. Their depth of occurrence in the thickness of the walls of the organ has not been clarified, the relationship of these structures with the epithelial lining of the stomach in relatively healthy people.

A comparative analysis of the case histories of patients with coronavirus infection who died and survived in the period 2020-2021 was carried out. The study confirmed the negative impact of comorbid conditions on the course and outcome of a new coronavirus infection COVID-19. Patients with blood diseases are at the greatest risk of adverse outcome. The structure of mortality from a new coronavirus infection COVID-19 is described. Respiratory failure and respiratory distress syndrome play a primary role in the mortality of patients from complications of Covid-19.
The reliability of the absence of the influence of age and gender on the course and outcome of a new coronavirus infection COVID-19 is shown. Comparison of laboratory parameters of the blood test between the studied groups of patients revealed a significant difference in the levels of lymphocytes, indicating the development of immune suppression, which led to an unfavorable outcome.
Medical-organizational (defects in therapy at the pre-hospital stage) and biological risk factors for deterioration or death from the new coronavirus infection COVID-19 were identified. The inexpediency of treatment with antibacterial drugs at the prehospital stage with a new coronavirus infection COVID-19 is shown. The inadvisability of prescribing antibacterial drugs at the prehospital stage and their negative impact on the severity of the condition upon admission with a new coronavirus infection COVID-19 is shown.

The structure of comorbidities in HIV infection is presented and the Charlson comorbidity index is assessed. A retrospective observational study was performed on the basis of the Infectious diseases department of the Osh interregional united clinical hospital (OIRUCH), the data of 130 patients with HIV infection for the period 2009–2021 were studied. Comorbidity in HIV infection occurs with a high frequency (76.9±3.7%), and in PWID it exceeds for 1.5 times. 26.2% of patients had a high Charlson comorbidity index (7–10 points), indicating a high probability of death within a year. The structure of comorbidity is dominated by infections of the skin and mucous membranes (55.4%), respiratory diseases (53.1%), liver damage (43.1%), AIDS-associated diseases (30.7%). Comorbidity becomes widespread in persons with HIV infection, especially among older patients. This indicates the need for special attention on the part of health workers, additional examinations to identify and treat comorbidity. The results of our study will help raise the awareness of healthcare professionals about the possible complex combinations of comorbidities among HIV- infected people.

Introduction. The problem of severe CNS lesions in patients with HIV infection is relevant. Objective of the study. Description of the spectrum of CNS lesions, determination of the diagnostic value of the presence and different concentrations of HIV RNA and DNA agents of secondary diseases in CSF and blood to verify the nature of encephalitis in patients with HIV infection. Materials and methods. 5485 patients with HIV infection were examined, 1310 with CNS damage. CSF (1667), blood serum (743) and blood plasma (3623) samples with the determination of pathogens DNA and HIV RNA were examined. Statistical software packages Statistica v. 10.0 and SPSS v. 20, programming language R, conjugacy tables with Pearson χ2 criterion, ROC analysis were used. Results. The spectrum of secondary neurological pathologies in patients with HIV infection, the frequency of detection and quantitative characteristics of HIV RNA, DNA of pathogens of neuroinfections in CSF are shown. The association between the amount of HIV RNA in the blood and CSF is statistically significant, but in 7.5% of cases, the concentration of HIV RNA in the CSF exceeded > 10 times the plasma value. Due to the high diagnostic sensitivity of the test, the absence of DNA of secondary disease pathogens and HIV RNA CSF excludes their role in the development of encephalitis. The diagnostic specificity of qualitative DNA determination of T. gondii, M. tuberculosis, C. neoformans, JCPyV is 100%. It is necessary to quantify HIV RNA, CMV DNA, EBV DNA, HHV-6 A/В DNA, Candida fungi in the CSF to confirm the etiology of the CNS lesion. Determination of CMV DNA in CSF at a concentration of > 16,600 copies/mL, blood leukocytes > 4.65 lg copies/105 cells, blood plasma > 62,700 copies/mL with 95% probability confirms CMV- etiology of encephalitis. Conclusion. Qualitative and quantitative determination of DNA of secondary disease agents and HIV RNA in CSF is crucial in timely decoding of the nature of neurological pathology in patients with HIV infection.

The aim is to study the difficulties of diagnosing echinococcosis of the liver and lungs, to evaluate the results of surgical treatment. Materials and methods. 47 patients with echinococcosis of the liver and lungs were operated on, 31 of them were diagnosed with echinococcosis of the liver, 9 - of the liver and lungs and 7 - of the lungs only. All patients underwent CT of the thoracic and abdominal cavities with bolus amplification. In surgical treatment, both traditional "open access" (80.85%) and mini-invasive (19.15%) were used. The immediate results of surgical treatment have been studied. Results. CT sensitivity for the diagnosis of echinococcal liver cysts was 93.02%, for the diagnosis of parasitic lung lesions - 80%. In the postoperative period, complications developed in seven cases (11.48%). Conclusion. CT sensitivity in the diagnosis of echinococcosis of the liver is higher than that of the lungs. There was no statistically significant difference in the number of postoperative complications depending on surgical access ("open" operations or mini-invasive).

The purpose of this study is to improve the results of surgical treatment of bleeding from the upper abdominal cavity in patients with cirrhosis through the use of active surgical tactics and a combined method of performing the operation.
An analysis of the results of surgical treatment of 62 patients with cirrhosis complicated by bleeding from the urinary tract, hospitalized at the Scientific Clinical Center of the Ministry of Health of the Kyrgyz Republic named after. M. Mamakeev. The control group consisted of 20 patients who were operated on according to M.D. Patsiora at a later stage due to the ineffectiveness of conservative treatment. In the main group of 42 patients with bleeding from the RVV, active surgical tactics were used using a combined method. The operation of M.D. Patsior was supplemented by the intraoperative introduction of a solution of ethoxysclerol in the form of microfoam into the veins of the esophagus above the ligatures and devascularization of the stomach. In the postoperative period, the effectiveness of hemostasis, the frequency of recurrence of gastrointestinal tract in the immediate and long-term periods were assessed, endoscopic monitoring of the condition of the esophageal mucosa was carried out after 6 months and after a year.
It was established that the choice of surgical tactics in favor of early surgical intervention in addition to a combined method allowed to improve the results of treatment of patients with cirrhosis with bleeding from the urinary tract. Postoperative mortality in the control and main groups was 60% and 9.5%, one-year survival rate in the control group was 37.5%, in the main group – 71.4%, respectively.

The aim of the work is to reduce postoperative suppuration of the residual cavities of the fibrous capsule of the liver through measures to prevent inflammatory complications.
There were 2 groups under observation: the first – 102 people, prophylaxis included intramuscular antibiotics and the second group – 82 patients, in whom prophylaxis included washing the residual cavity with decasan and its active drainage. In the control group, when using antibiotics to prevent suppuration of residual cavities, complications were detected in 15 (14.8%), and in the second group, where preventive measures were applied in 7 (8.5%).
Laboratory and experimental methods substantiate the use of decasan in the disinfection of the fruiting elements of echinococcus.

The aim of the study was to optimize diagnostic monitoring, preoperative preparation, and choice of surgical treatment tactics for patients with hepatic echinococcosis and cirrhosis, which developed as a result. The report is based on the results of the treatment of 578 patients operated in the clinic. The diagnosis of liver cirrhosis before the operation was established in 14 cases, and intraoperatively in 8 cases. Noncommercial fibrin glue was used to stop the bleeding. A suspension of mononuclear cells prepared from the recipient's blood was used to activate the reparative processes and to prevent postoperative complications, which improved the treatment results. Liver cirrhosis is not a contraindication to echinococectomy. Diagnostic monitoring should include the full arsenal of available tools. Minimized surgical tactics and intensive postoperative treatment allows to achieve good results and reduce postoperative mortality.

Objective: to evaluate the features of the clinical course of liver echinococcosis case with attached CT and MRI images. Material and methods: surgical material, results of ultrasound diagnostics, CT and MRI, observations of a clinical case on the basis of BUZ UR "1 RCB of the Ministry of Health of UR" were used. Results: As of 2022, 73 patients with liver echinococcosis are under the dynamic supervision of surgeons and infectious diseases specialists at the Republican Clinical Infectious Diseases Hospital. A total of 66 patients were operated on, 7 of them were operated in the BUZ UR "1 RCB of the Ministry of Health of UR" for 2020-2022. Conclusions: Echinococcosis has been and remains a serious and topical human parasitic disease. Despite the study of this disease, diagnosis remains difficult due to the fact that the examination of the patient does not contain specific symptoms for diagnosis. In recent years, the clinic has begun to introduce endoscopic methods oftreatment that improve the prognosis of a speedy recovery. The immunohistochemical method showed high efficiency in the diagnosis of echinococcosis.

To improve the results of surgical treatment of liver alveococcosis, an analysis of the results of surgical interventions in 23 patients to remove liver alveococcosis was carried out in the period from 2013 to 2023.
Four patients were operated on with alveolar echinococcosis spreading into the intrahepatic segment of the inferior vena cava.
All cases of parasite germination into vascular structures required resection of the latter with prosthetics with vascular alloprostheses. In one case with damage to the inferior vena cava up to a critical circular narrowing of up to 5 mm. The parasite was removed from the liver, outside the patient’s body with the formation of vascular elements on the “Back Table”.
Performing liver allotransplantation with resection and plastic surgery of the great vessels, including resection of the inferior vena cava, can serve as the only radical method of treating “unresectable” alveococcosis of the liver, allowing for satisfactory immediate and long-term results of surgical treatment of seemingly doomed patients.

In the conditions of Kyrgyzstan, operations to create portosystemic anastomoses are not only a measure for the prevention of bleeding from the Varicose veins of the esophagus and stomach, before liver transplantation, but also the final method of treatment for this category of patients, because for many patients there is simply no possibility for radical surgical treatment of cirrhosis.
The experience of surgical treatment of 153 patients with portal hypertension from 1997 to 2016 was analyzed.
Proximal splenorenal anastomosis (PSRA) with splenectomy was formed in 78 (50.9%) patients. Of 78 (50.9%) patients, 55 (35.9%) patients underwent standard splenectomy with the formation of an end-to-side PSRA. In 3 (21.4%) patients, interventions were performed at the height of bleeding from varicose veins of the esophagus, the remaining 11 (78.6%) patients were performed as planned. PSS thrombosis developed in 13 (8.5%) patients, the largest number of thrombosis occurred in PSRA, in 10 (6.5%) of 13 cases, which is possibly associated with the greatest trauma to the pancreas. 7 (4.6%) patients died from relapse of Gastroesophageal bleeding due to thrombosis of the portosystemic shunt.
Rules that must be followed to minimize complications: the use of the lower pole branch of the splenic vein to form portioned proximal splenorenal anastomosis, this allows: to preserve hepatopetal blood flow; control the patency and consistency of the anastomosis; prevent thrombosis of the anastomosis.We consider the splenorenal side-to-side anastomosis to be the most physiological and effective organ-preserving portosystemic shunt.

This article presents the results of a survey of the prevalence and structure of minor heart anomalies among 38598 schoolchildren aged 6 to 16 years in the Kyrgyz Republic according to echocardiogram (echo) data. The survey was performed by questionnaire, general clinical examination with auscultation of the heart. Echocardiographic examination was performed in 2919 children (7.56%) with a heart murmur. echo was performed according to the standard technique on a portable SonoscapeS9 device manufactured by SonoScapeMedicalCorp. On the basis of the study the authors revealed the following: congenital heart defects (CHD) requiring surgical intervention amounted to 0.5%, and with small heart anomalies - 3.5%. In the structure of small cardiac anomalies, an abnormally located extra chorda is common, and aneurysm of the interventricular septum and tricuspid valve prolapse are detected less frequently. Taking into account these studies, the article notes that minor cardiac anomalies do not lead to obvious hemodynamic abnormalities, as heart defects, but can worsen the quality of life, as well as cause pathologic conditions threatening the life of the patient.

Infantile hematoma is the most common vascular tumor in childhood, which in most cases resolves on its own. However, in some cases, with aggressive growth, the disease can occur with complications. The purpose of this work was an integrated study of risk factors for the development of infantile hemangioma. The study involved 138 patients, including 69 patients diagnosed with infantile hemangioma, aged 6-78 months. The control group was formed from 69 healthy children comparable in number, age and gender with the children of the main group. Anthropometric data were assessed and socio-demographic characteristics, medical history, and family history were analyzed in patients with IH using a developed patient monitoring form. Based on these data, the ranking significance of risk factors for the occurrence of infantile hemangioma in children was calculated. This study showed that antenatal factors and heredity have the highest probability of occurrence of the disease. Peri- and postnatal factors were of low significance. Further scientific research should be aimed at studying the relationship between risk factors and their influence on the further course of the disease.

We examined 45 young children with nosocomial rotavirus infection who received inpatient treatment at the Republican Clinical Infectious Hospital (RCIH). Clinical and laboratory characteristics of nosocomial rotavirus infection in young children are given. As a result of the study, nosocomial rotavirus infection is often (86.4%) registered among children of the first year of life who are on artificial and mixed feeding. Basically, children with rotavirus infection were admitted in the cold season and were residents of Bishkek (64.3%), by gender showed that both boys (50%) and girls (50%) were equally ill. The disease began acutely with symptoms of gastroenteritis and proceeded mainly in severe form (73.8%) due to the formation of mixinfection and complications. It should be noted that the stay in other hospitals in children under one year lasted for 7.3±2.4 days, in children under 3 years 3.6±1.2 days. The diagnosis was confirmed by express diagnostic methods: a rota test in 78.5% of patients and PCR analysis of faeces. For timely diagnosis of nosocomial RVI, it is necessary to use express diagnostics by latex agglutination reaction (rota test) and PCR analysis.

This article provides a comparative description of changes in the level of growth hormone and blood cortisol in adolescents with the development of meningitis of various etiologies. The study was conducted on 48 patients aged 10 to 19 years. In comparison, the groups of patients with acute bacterial and serous meningitis are presented. The results of the study help to determine what metabolic disorders can occur with meningitis of various etiological agents, which aggravates the course of the disease, increases the risk of complications and death, as well as to build a tactics of treatment and management of such patients. Particular attention is paid to the development of stress hyperglycemia — a condition that significantly aggravates the course of a generalized infectious and inflammatory process and increases the risk of complications from many body systems.

The article analyzes the literature data on the etiology, clinical features, modern methods of diagnosis and treatment of acute infectious secretory diarrhea in young children at the present stage. During the analysis of literary data, it was found that the predominant etiological factor of acute intestinal infections in young children are viruses and bacteria that cause the secretory type of diarrhea. In 80,0-90,0% of cases, the etiology of viral secretory diarrhea is rotaviruses. A common cause of bacterial secretory diarrhea in young children is E. Coli (83,4%). Also, in children during long-term intensive antibacterial therapy, the cause of secretory diarrhea can be bacteria of the genus Clostridium difficile. Acute infectious secretory diarrhea is characterized by the appearance of symptoms of gastroenteritis. However, the duration and severity of clinical manifestations of secretory diarrhea and general infectious syndrome depend on the specific etiological factor. The severity of the condition of children with infectious secretory diarrhea is due to the development of
mixed infection, sepsis and dehydration, which contributes to an unfavorable outcome of the disease.

The article presents data on the use of the drug ursodeoxycholic acid in hepatomegaly and fatty hepatosis in 50 obese adolescents. The purpose of the work was to study metabolic disorders in obesity in adolescents and the effectiveness of the use of ursodeoxycholic acid in correcting these changes. The subjects of the study were 50 obese adolescents aged 10 to 18 years. The teenagers were divided into 2 groups of 25 people using random sampling. Children of the main group, in addition to non-drug treatment, received the drug ursodesocholic acid in an age-appropriate dosage. The analysis was carried out according to objective examination, instrumental and laboratory studies. Based on the analysis data, it was found that the condition of the liver in adolescents with obesity is characterized by changes in the form of liver enlargement, the appearance of fatty hepatosis and changes in the lipid profile. After completing the study, it was concluded that there was a significant positive clinical and functional dynamics of the disease in the first group while taking ursodeoxycholic acid. In the second group, there was a lack of dynamics and even some deterioration in clinical and functional indicators.
The use of ursodeoxycholic acid drugs in addition to non-drug treatment leads to a significant improvement in clinical symptoms and lipid metabolism in adolescents.

Purpose of the study: to conduct a retrospective analysis of the characteristics of the clinical picture of pneumonia with positive and negative tests for COVID-19 in children withbronchial asthma in children in the Kyrgyz Republic. Materials and methods. The case-control study  compared two groups aged 7 to 17 years who were ill from September 2020 to February 2021. The clinical and laboratory characteristics of Covid-19 pneumonia in children with bronchial asthma were studied. Results: The pattern of Covid-19 pneumonia differed from usual pneumonia in children with asthma (p<0.001). A correlation was identified between data in the anamnesis of children with bronchial asthma and Covid-19 diseases in children with existing bronchial asthma (p<0.001). Conclusions: Susceptibility to Covid-19 was observed in children with existing asthma. Children with uncontrolled asthma had an increased risk of hospitalization and more severe asthma.

The article presents the current state of knowledge of enterovirus infection in the Kyrgyz Republic. Over the past 25 years, enterovirus infection has been studied not as a whole pathology, but only some of its types, mainly in children. According to the Republican Infectious Diseases Hospital in Bishkek, a retrospective analysis of the incidence of enterovirus infection over 10 years and enteroviral meningitis for the period 2015-2018 was carried out. Various clinical types of enterovirus infection (exanthema, myalgia, diarrhea, vesicular pharyngitis and stomatitis) are registered in the Chui region, and serous meningitis is significant in their structure. 102 case histories of children hospitalized with a diagnosis of enteroviral meningitis were analyzed. The diagnosis was based on clinical, epidemiological and laboratory data. In the age aspect, specific pathognomic symptoms of serous meningitis are described, as well as its combination with other types of enterovirus infection (upper respiratory tract catarrh, exanthema, gastroenteritis, herpangina). The need for differential diagnosis of enterovirus infection with other infectious and non-infectious pathology using specific methods for diagnosing this infection is shown.

Differential diagnostics of clinical and laboratory data was carried out in 665 children and teenagers diagnosed with Measles and Parvovirus B-19 infection, who were hospitalized at the Republican Clinical Hospital for the period from 2018 to 2022. Among the observed patients, patients with measles amounted to 619 people, and patients with parvovirus infection B-19 - 46. The epidemiological features of these diseases are considered in detail. The age structure of the compared exanthems, the features of the seasonal rise in the disease, as well as the frequency of identified contacts with an infectious patient are presented. The most important features of the clinical course of measles and parvovirus B-19 infection in children and adolescents have been identified. Specific, pathognomonic symptoms were described that were characteristic of each of the considered viral diseases. During the analysis of statistical data, the chances and risks of developing severe forms of the disease, as well as complications from measles and parvovirus B-19 infection, were presented. From laboratory research methods, PCR and ELISA methods were used to confirm the etiology of the diagnosis. Also, general clinical and biochemical research methods were used as a comparison in the two observed groups of patients. The results obtained will improve differential diagnosis and timely prescribe adequate treatment.

A comparative analysis of clinical and laboratory data was carried out in 676 children diagnosed with “Measles” (619 people) and “Enteroviral exanthema” (57 people), who were hospitalized at the RCIH for the period from 2018 to 2022. The main epidemiological and clinical laboratory features of the course of measles and enteroviral exanthema in children have been determined. It was found that young children were more likely to suffer from measles; for enterovirus infection, older patients were more often observed. To clarify the diagnosis, the ELISA and PCR methods and the Cer Test Enterovirus rapid test (immunochromatographic analysis for the qualitative detection of enterovirus in feces) were used. The clinical picture of measles was characterized by periodicity, the staged appearance of a maculopapular rash followed by pigmentation and peeling, while with enteroviral exanthema the rash was more varied. Severe forms of the disease were recorded more often with measles than with enterovirus infection. Enteroviral exanthema was also characterized by myalgia with arthralgia, hypertrophy of lymphoid tissue, and abdominal pain, which is associated with polymorphism of clinical manifestations. The results obtained will improve differential diagnosis and promptly prescribe adequate treatment.

The study included 20 patients with adjacent segment disease who were re-operated using the ALIF technique from 2019 to 2022. All patients were divided into two groups depending on the surgical technology. The first group included 11 patients aged from 30 to 60 years (M ± SD = 48.0:11.9 years) who underwent surgery using ALIF technology using interbody implants. There were 6 men (54.6%), 5 women (45.4%). The second included 9 patients aged 35 to 55 years (M ± SD = 42.4:8.6 years), operated on with ALIF technology using an M6 intervertebral disc prosthesis. The ratio of men to women in this group was 5 (55.5%):4 (44.5%). In group I, anterior decompression of the spinal canal using the ALIF method with the use of interbody implants, statistically significant results were observed: VAS before surgery 7.5 ± 0.9 – after 2.2 ± 1.3 p < 0.001, ODI index before surgery 52.4 ± 8.8 – after 14.5 ± 6.9 p <0.001. In ALIF group II using M6 intervertebral disc endoprosthesis, significant results were also noted: VAS before surgery 8.1 ± 0.9 – after surgery 1.2 ± 0.2 p <0.001, ODI before surgery 63.6 ± 9.9 – after 11.5 ± 4.2 p <0.001. However, ODI indicators in the second group in a comparative analysis are better than in group I, p <0.05. Thus, the long fixation lever, the level of spinal fusion, influences the development of diseases of the adjacent segment. In the present study, we performed a comparative analysis using ALIF technology using a conventional titanium cage and an endoprosthesis. We came to the conclusion that by using an intervertebral endoprosthesis as an alternative to spinal fusion, it is possible to reduce the risk of progression of degenerative changes in adjacent segments and the development of diseases at adjacent levels.

Olfactometry (the study of the olfactory function) involves the use of quantitativemethods to study the acuity of smell (determining the thresholds for the perception of odorous substances, the time of adaptation and recovery of smell), as well as qualitative methods to identify the ability to recognize and differentiate odors [1]. To determine the degree of damage, methods for determining the olfactory function using olfactometry were considered. We also analyzed the available olfactometry methods in the CIS countries, the USA and Europe. After the analysis, we have selected a modified set of olfactometry, more suitable for working with residents of the Kyrgyz Republic. The proposed set includes 9 odorants - odorants easily recognizable by patients. Odorants are presented in the form of solutions and placed in vacutainers. In the course of the work, indicators of the norm of the olfactory function were determined, as well as the prevalence of the level of damage to the olfactory analyzer. A possible relationship has been identified between the age of patients who have had a coronavirus infection and their ability to restore their sense of smell. The work done makes it possible to carry out olfactometry at all levels of otorhinolaryngological care and in the future to approach the treatment of disorders of the olfactory analyzer in more detail.

The epidemiological situation of echinococcosis in the conditions of the Karachay- Cherkess Republic in 2010-2022 was studied, for which the medical reporting on the CR was analyzed. The average incidence rate of the KCR population was 4,0±0,4 (per 100 thousand people), the minimum age at which echinococcosis was registered fell on a child of 2 years, the maximum age of the patient was 107 years. The share of the adult population for the analyzed period accounted for 74,5%, including at various ages, the incidence was distributed as follows: 18-29 years – 32,1%, 30- 39 – 21,4%, 40-49 – 14,7%, 50-59 – 18,3%, 60-69 – 8,0%, 70 years and older – 5.4%. The share of the child population was 25,5%. Children aged 3-6 accounted for 11,2%, 7-13 years – 62,5% (50
cases), 14-17 years – 25,0% (20 cases). In the gender structure of patients, there is a slight predominance of the female population, which accounted for 52.2%.

This article reflects the epidemiological study of cystic echinococcosis cases from the last decade. The chirurgical cases of cystic echinococcosis, recorded in 2011-2020, were included in this study. To evaluate the morbidity level, intensive (morbidity indicators) and extensive (case distribution according to sex, age, and place of residence) indexes were calculated. Even though the morbidity is decreasing, the Republic of Moldova still is part of the hyperendemic countries of South - Eastern Europe. This disease is often encountered in regions where shepherding is traditionally more developed. It affects people of all ages, especially children and young adults. The echinococcosis control system would have to be based on cooperation between medical and veterinary services, with the latter taking on a leading role. 

The article discusses the results of scatological and pathoanatomical studies of dog feces from the districts of the Osh and Naryn regions of the Kyrgyz Republic. In the Osh region, the incidence of Taenia species (Taenia sp.): eggs in dogs was established: during a scatological examination – 10.3±1.2%, during a postmortem autopsy – 24±4.1%. In Osh region, out of 104 examined dogs, 10.5% were infested with Echinococcus granulosus, and 13.4% with Echinococcus multilocularis. The most affected by E. granulosus were dogs from the villages of Sary-Tash and Chon Kara-Kol of the Alai region, where the infestation of animals was 33.3% and 12.5%, respectively, and in the village of Kashka-Suu of the Chon-Alai region - 14.5%. In the Naryn region, a scatological examination of feces revealed the infestation of dogs with Taenia sp. eggs – 9.6%, with a postmortem autopsy – 47.5%. E. multilocularis was found in all surveyed settlements: p. Bash-Kaiyndy, At-Bashy urban-type settlement, Acha-Kaiyndy village - 40% each, Tash-Bashat village - 50%, Naryn city - 33.3%. Synanthropic foci of alveococcosis were revealed.

The goal: analyse the experience of combination during educational process traditional technologies and innovations. It allows for students to arrange the scientific material during studying of some chapters of medical parasitology and understand the importance of fundamental knowledge for their future practical medical activity. Material and methods. The example of case-study that was elaborated by authors to study the tapeworms – agents of cystic echinococcosis and alveolar echinococcosis is given. Results. Test control of current knowledge of students and validation of tasks inside case demonstrated good and excellent (75%) levels of assimilation of educational material by the students.

This article analyzes the normative legal acts related to the accreditation and requirements for clinical residency and continuing education of orthodontists in Osh city, Kyrgyzstan. The study explores the demands placed on orthodontists working in both public and private dental clinics, as well as provides an analysis of the accreditation status and specialization of orthodontists in these establishments. The research highlights discrepancies in requirements and regulations for orthodontists and identifies issues pertaining to the lack of necessary certifications and specialization among some orthodontists in private clinics. To ensure the quality of healthcare services, we propose a thorough examination of the documentation and implementation of measures to regulate the activities of orthodontists in accordance with the relevant normative legal acts. This study holds significant importance for enhancing the quality of orthodontic care in Osh city and can serve as a starting point for further research in this field.

Zoonotic invasions are widespread on the territory of the Russian Federation, one of them is echinococcosis. In this regard, the purpose of the study was to study the spread of echinococcosis of farm animals in Russia on the basis of quarterly and annual reports of the 1-vetform for 2020 - 2023, submitted by the Center for Veterinary Medicine, as well as the results of our own research - conducting a veterinary and sanitary examination of carcasses and internal organs of cattle (521) and sheep (899) from four economic regions of the Russian Federation: Central Black Earth, Central, Volga and North Caucasus. Veterinary and sanitary examination of carcasses and internal organs was carried out in accordance with the Technical Regulations of the Customs Union"On the safety of meat of meat products" dated 09.10.2013 No. 68 TR CU 034/2013 and "Veterinary rules for the appointment and conduct of veterinary and sanitary examination of meat and slaughter products ( fishing) of animals intended for processing and (or) sale”, approved on April 28, 2022 by the Ministry of Agriculture of the Russian Federation (Order No. 269). Based on the analysis of the 1-vet form reports, it was found that deer were the most infested: EI = 6,6% in 2020, 7,4% - in 2021, 6,4% - in 2022 and 0,4% - in 2023 During the veterinary and sanitary examination, the authors found that echinococcosis of cattle was diagnosed in the Central region, out of 295 carcasses 6 turned out to be infested, which corresponds to 2,03%, the Central Black Earth and Volga regions are safe, and there are no data on the North Caucasus, Since there were no carcasses and internal organs for research in the Moscow region, the extensiveness of invasion (EI) in Russia was 1,2%. In sheep, the highest percentage of infection with echinococcosis was diagnosed in the Volga region (EI = 41,9%) and the North Caucasian regions (EI = 31,5%), in the Central region a single case of detection of larvocysts in sheep was detected (EI = 0,4%), in Russia EI=23,6%.

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