Vol. 5 No. 5 (2023): VESTNIK of KSMA

This article presents the features of the organization of medical education in various countries, such as the USA and Great Britain, since medical professions in these countries are ranked among the highest paid and most prestigious professions. Also given are characteristics of medical education in Europe, which are somewhat different from English-language medical education. These differences are presented using the example of the organization of medical education in Germany. The article provides information about medical education in Kyrgyzstan. About its stages and degrees, at undergraduate and postgraduate levels, at faculties in various specialties, which is different from medical education in the USA or UK, but nevertheless there are similarities with education in Germany.

The analysis of the occurrence of craniofacial trauma among children and adolescents was carried out. The causes of injuries, their types and treatment are investigated. The data of the results of diagnosis and treatment of a group of victims who were hospitalized were studied. The proportion of these patients was 19.4% among patients of the department of maxillofacial surgery and neurotraumatology. Work or operation of agricultural equipment, wood processing, falling from a height, injuries inflicted by domestic animals were the main causes of craniofacial injury. The practice of involving children and adolescents in agricultural work should be prohibited, since severe injuries to the facial skeleton and soft tissues can lead to violations of the physical and mental development of children.

This article presents materials on the study of epizootology and epidemiology of echinococcosis in Yakutia. Echinococcosis in Yakutia occurs in both wild and domestic animals, and is one of the most dangerous infestations for humans. According to the degree of infection with mature cestodes and cystic echinococcosis of animals, the presence of natural foci is determined, where the fundamental factor is the circulation of the transmission of invasion from the final hosts to intermediate ones and vice versa. In most cases, human infection with echinococcosis occurs through contact with carnivorous animals, removal, processing of skins of harvested carnivores, with the carcass of harvested wolves, foxes exposed "for exotic photographing", when bringing frozen
carcasses of animals into residential premises and using wild plants contaminated with echinococcus oncospheres (berries, onions, herbs, etc.). Genotypes cestodes and larval cyst associated with the life cycles of livestock and found in the wild, which include wolves and moose, reindeer as hosts.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a potentially curable disease, the course and outcome of which largely depend on the timing of the start of pathogenetic therapy, so early diagnosis is important. In turn, untimely treatment of CVDP is accompanied by secondary axonopathy, the consequence of which is severe residual neurological deficit, deterioration of working capacity and quality of life of patients. The aim of the article was to describe a clinical case of atypical course of chronic inflammatory demyelinating polyneuropathy in a patient with comorbid pathology. Clinical data and the results of laboratory and instrumental methods of investigation were analyzed. As a result of successful treatment of the patient with intravenous immunoglobulin, significant improvement of the condition and restoration of lost motor functions were observed. The presented clinical case is an example of a long and complicated diagnostic search on the way of making the correct final diagnosis. The article may be useful for both young and experienced neurologists and related specialists, such as intensive care doctors, rheumatologists, rheumatologist, family doctors, cardiologists, therapists, and others.

Objective: To enhance outcomes in endovideosurgical treatment for patients with chronic coprostasis associated with decompensated dolichosigma. Methods: Patients with chronic constipation treated at City Multispecialty Hospital No. 2 in Astana from 2019 to 2023 underwent laparoscopic left-sided hemicolectomy using a specialized technique for decompensated dolichosigma and chronic coprostasis. Of the 28 patients admitted during this period, 25 received surgery using the new technique, while three urgently underwent surgery for acute intestinal obstruction. Patients in the new technique group had a shorter hospital stay (7-8 days) compared to those with traditional sigmoid colon resection (12.0 ± 1.1 days). Comprehensive assessments included clinical and laboratory studies, instrumental examinations, and microbiological investigations. Laparoscopic equipment was used for all surgeries. Results: The new surgical method led to an average hospital stay of 7-8 days, shorter than the traditional surgery group's 12.0 ± 1.1 days, with no postoperative complications. Comprehensive rehabilitation after surgery was followed by 6 to 12 months of medical monitoring. Colonic function fully recovered in the new method group, marked by regular, well-formed stools without laxative use. Patients reported an improved quality of life and a return to work activities during follow-up. Conclusion: The enhanced endovideosurgical approach for managing coprostasis in patients with decompensated dolichosigma substantially diminishes the occurrence of procedure-associated complications, leading to a reduction in the duration of postoperative recovery and temporary work incapacity for affected individuals.

Objective. To evaluate the effectiveness of endoscopic retrograde stenting of the extrahepatic bile ducts and the main pancreatic duct in malignant diseases and benign lesions of the pancreatobiliary zone.
Materials and methods. Over the past six years, endoscopic retrograde stenting of extrahepatic bile ducts has been performed in 509 patients at the Perm Regional Clinical Hospital: 450 with malignant diseases, 59 with benign lesions. Plastic and partially covered self-expandable metal stents were used for primary stenting. After the intervention, the patients were observed for 1-3 years. According to the indications, repeated endoscopic interventions were performed.
Results. Out of 450 patients with malignant diseases, the stent was able to be installed in 421 cases (93.55%): in 356 cases - plastic, in 65 - self-expandable. In six cases (1.42%) there was post- sphincterotomy bleeding. The plastic stent was replaced from two to seven times after 2-5 months (median 4), 37 patients were replaced with a self-expandable one. In 29 cases, a second stent was performed, and 13 more patients managed to install a "stent in a stent" during occlution of a self- expandable stent. The median life expectancy ranged from 4.5 to 11 months.
Stenting with external biliary and pancreatic fistulas in 31 patients led to their closure. In benign strictures of bile ducts, plastic stent replacement was performed in 3-4 months in 28 patients at least three times.
Conclusion. Endoscopic retrograde stenting of the bile ducts allowed in 93.25% of cases to eliminate mechanical jaundice in malignant neoplasms of the pancreatobiliary zone. In case of obstruction of plastic and self-expandable stents, it is possible to carry out a second stent or use the "stent to stent" technique. Endoscopic installation of stents in the bile and main pancreatic ducts above their defect in the presence of external bile or pancreatic fistulas leads to their rapid closure.

Acute destructive pancreatitis is a formidable surgical disease that poses a serious problem due to its geographical distribution; the severe form of which is associated with high morbidity and mortality. At the same time, mortality, depending on the volume of the inflammatory process of the pancreas and the severity of the pathology itself, remains at a level of 20% and above. The purpose of the study was to summarize the literature data on the experience of researchers over the past 10 years devoted to the search for the most effective methods of surgical treatment in combination with drug therapy for acute destructive pancreatitis. Pub med, Medline, publications from journals of the CIS countries and the Republic of Kazakhstan were used. After a comprehensive and standardized assessment, only studies that presented experience in complex treatment of acute destructive pancreatitis, including continuous regional arterial administration of drugs, were taken into account.

Introduction. The article presents the data and results of treatment of children with esophageal atresia who were hospitalized with this pathology in the neonatal intensive care unit with surgical pathology on the basis of the clinic of the national center for maternal and child health care Study Objective. To analyze the methods of surgical correction for various types of esophageal atresia and the results of their treatment in newborns.
Materials and Methods. From 2016 to 2022, 62 newborns with esophageal atresia were admitted to the intensive care unit of newborns with surgical pathology at the National Center for Maternal and Child Health in Bishkek.
Results and discussion. In the context of this pathology, almost all children were born prematurely at 38-39 weeks gestation. But 14 newborns had delayed intrauterine development. All newborns were hospitalized in the neonatal intensive care unit on the first day of life. Most of all 31 newborns with esophageal atresia were admitted from Chui oblast, Bishkek 19, Issyk-Kul 19, and Issyk-Kul 19. Bishkek 19, Issyk-Kul region 3, Naryn region 2, Talas region 1, Osh region 3, Batken region 1, Jalal-Abad region 2 newborns.
Conclusion. Modern treatment methods, careful preoperative preparation and high-tech surgery in newborns and advances in neonatal intensive care have achieved good success in the treatment of patients with esophageal atresia.

The article is devoted to an actual problem in pediatrics - malformations of the central nervous system, such as Dandy-Walker anomaly and pachygyria. In world practice, over the past 5 years, many studies have been carried out to identify statistics on congenital malformations of the central nervous system in children. In this article we will introduce you to several foreign articles where the results of the research were published. And also with a clinical case from our practice.
Clinical-anamnestic, laboratory-instrumental, social aspects and problems of prenatal diagnostics are briefly described. The article presents our own observations of the Dandy-Walker syndrome in combination with pachygyria in a 4-month-old boy, and the results of magnetic resonance imaging.
The analysis involved the use of domestic and foreign sources containing evidence-based, experimental and clinical evidence on the most modern issues related to the study of the current topic in the field of pediatrics and child neurology, “Congenital malformations of the central nervous system.” Publications were studied using the resource of search engines of various scientific.

Target. To study the population frequency of congenital cleft lip and palate among children in the Sughd region. Material and methods. The object for a retrospective epidemiological study was 346 newborn patients with congenital cleft lip and palate who applied to the departments of maxillofacial surgery in the Sughd region for the period 2017-2021. Results of the study. In the Sughd region, a high incidence of congenital cleft lip and palate among newborns was established (n=346; 69.2%). The highest incidence rate (25.7%; n=89) was registered in 2018, the lowest (5.5%; n=19) - in 2020. The ratio of boys and girls M:D 1.8:1. A significant number of newborns with CVHH were admitted to the dental departments at the age of 0-3 years and 3-8 years, which amounted to
61.0% (n=211) and 23.7% (n=82), respectively. At the same time, the majority of patients with CVVHiN in the Sughd region live in rural areas (n=287; 83.0%). Conclusions. The population frequency of VRVHiN among children in the Sughd region is 346 cases, of which 241 patients had a

The provision of medical care to newborns with developmental defects in the Karaganda region until 2017 was carried out only in the Regional Children's Hospital, since the preservation of life and health of this complex contingent of patients was impossible without the participation of neonatal transfer. However, along with a positive assessment of the transfer of a child with congenital malformations for assistance to a children's medical institution, negative aspects of the transfer were also identified. Complications that develop during transportation, according to researchers, can cause unfavorable treatment outcomes. One of the factors of increased mortality of newborns with congenital malformations is a violation of the "heat chain" during transportation from one hospital to another, which worsens the condition of the newborn, increases the development of metabolic disorders, and postoperative complications. Considering that, the Karaganda region is the largest area of Kazakhstan, transportation can take from 3 to 7 hours. The purpose of the article is to reduce the mortality of newborns with congenital malformation in the Karaganda region by excluding thetransportation of newborns from one hospital to another and nursing by neonatologists in the postoperative period in perinatal centers. During the reporting period 2018-2023, the mortality rate of newborns with congenital malformations operated in maternity hospitals in the Karaganda region decreased from 53.8% (2017) to 13% (2023).

The aim was to investigate the information content of the method of computer capillaroscopy of the nail bed, which allows to determine the state of the capillaries in real time. The method was applied in the examination of 238 patients aged 2 to 17 years with prolonged and chronic cough.
In the course of studying the structural features of the microvasculature in respiratory pathology of various genesis, we found that the capillary network in patients with allergic respiratory diseases had weak differentiation at the level of the 3rd capillary echelon, as well as a high incidence of morphologically altered capillaries (glomerular, arborescent) (p< 0.05). It was also found that in
allergic respiratory diseases, significant changes in the arterial part of the capillaries were detected
and the length of the perivascular zone was significantly higher, especially in bronchial asthma,
compared with that in patients with infectious and inflammatory diseases of the respiratory system
(p<0.05).
In patients with infectious and inflammatory diseases of the respiratory system, a change in the
parameters of the venous section of the capillaries was more often observed, which may indicate a
decrease in the processes of adaptation of the capillary bed when exposed to an infectious agent. At
the same time, more pronounced morphological changes were characteristic of patients with lower
respiratory tract infections, in contrast to children with acute or exacerbation of chronic diseases of
the upper respiratory tract.
Thus, significant changes in the arterial part of the capillary network in patients with allergic
respiratory diseases, a significant increase in the length of the perivascular zone, indicating an
increase in the degree of hydration of the interstitial space due to chronic allergic inflammation, are convincingly shown, which can be used for differential and early diagnosis.

Purulent septic diseases in children are still an urgent problem to date. For pediatric surgeons, orthopedic traumatologists and intensive care specialists, deep bone damage, or osteomyelitis, is a matter of general interest due to the frequent development of complications and chronization of the process. The article analyzes and systematizes the results of scientific research published in the databases PubMed, ScienceDirect, eLibrary to improve the practice of antimicrobial drugs in surgical urology.
Despite the widespread introduction of modern diagnostic methods, the issue of clear indications for various examination methods, the timing and sequence of the above measures remains debatable to date.
The main cornerstone is the use of antimicrobial drugs in the treatment of acute hematogenous osteomyelitis in children, as well as the development of measures to curb the growth of antibiotic resistance. To date, the issue of choosing surgical treatment tactics and determining clear indications for their implementation and determining the timing of surgical interventions remains ambiguous.
Improving measures to improve the quality of diagnosis and determining the tactics of managing patients with acute hematogenous steomyelitis contributes to improving the effectiveness of early and late treatment results, improving the quality of life and reducing the risk of disability in children.
Conducting in-depth research aimed at improving therapeutic and diagnostic measures in children with acute hematogenous osteomyelitis is an urgent and in-demand measure aimed at providing high- quality and safe medical care for children and the state as a whole.

In the article, the authors note an increase in the frequency of complications after open methods of appendectomy, but at the same time, open methods of treating complicated forms of appendicitis in children remain relevant today, since in many ways the outcome of treatment of patients with appendicitis complicated by peritonitis depends on adequate surgical tactics and reliable eliminating the source of peritonitis. Access, sanitation and drainage of the abdominal cavity, as well as decompression of the small intestine for diffuse appendiceal peritonitis remains the method of choice for many operating surgeons. Biochemical blood parameters in patients with appendiceal peritonitis after surgery are uninformative and do not provide a clear idea of the severity and dynamics of progression of the pathological process. Nonspecific CRP is the most highly sensitive indicator of inflammatory activity. A study was carried out of the pH environment of the abdominal cavity during and after open appendectomy and complex treatment of peritonitis, which included drainage of the abdominal cavity through access in the right iliac region with glove drainage with the introduction of a 0.5% solution of salicylic acid in a volume of 1 ml on the second day. When analyzing the results of complex treatment of patients with acute appendicitis complicated by appendiceal peritonitis of various forms with the use of salicylic acid 0.5%, a change in the pH of the medium towards normalization was noted from the 5th day, which also correlated with general clinical signs of improvement in the patient’s condition. Complex treatment of appendiceal peritonitis with the use of salicylic acid improves the final results in the early and late postoperative period in children by 4.3%.

The article "Experience in the treatment of urodynamic disorders in children with spina bifida" reflects the difficulties that patients have after the correction of spina bifida on the basis of City Child Clinical Hospital Emergency Care. Regardless of how successfully the correction of the hernia itself is performed, the risk of developing urodynamic disorders remains quite high. These are mainly recurrent urinary tract infections due to residual urine, vesicoureteral reflux and hyper- or hypo-reflex bladder. All these disorders in the urinary system cause difficulties in maintaining a normal life, adapting to society, and eventually lead to the development of chronic renal failure. A complex mechanism for coordinating the work of the lower parts of the urinary system makes it difficult to treat this group of children. In the analysis of treated children with spinal dysrraphism, it was found that the frequency of occurrence between the female and male sex was 2:1. Immediately after birth, 18 patients had lower flaccid paraplegia, urinary incontinence in 10, and anal gaping in 4 patients.

In terms of examination, both laboratory examination methods (general blood count, general urinalysis, biochemical blood test, bacteriological culture of urine) and instrumental methods (ultrasound of the kidneys and urinary system, cystography, urography) were carried out. Reccurent infections of the urinary system were detected in 18 (78.2%) children. Residual urine was detected in 11 (47.8%) children. Ureterohydronephrosis was detected in 3 patients.
In the treatment used: for infections of the urinary system uroseptics; with ureterohydronephrosis, periodic catheterization of the bladder with positive results. Anticholinergic therapy, surgical interventions on the upper and lower urinary tract were not performed. The data of this study show us the need to continue developing a treatment and rehabilitation regimen for this group of patients.

The search for specific prognostic and diagnostic markers is an urgent task in modern pediatrics. The endothelium is an active system that functions as a receptor-effectors organ that responds to an exogenous or endogenous stimulus with the release of various molecules designed to restore vascular-tissue homeostasis. The endothelium, on the one hand, is involved in almost all processes defined as homeostasis, homeostasis and inflammation, on the other hand, it is the first link in the pathogenesis of various diseases in both adults, children and adolescents. To date, the idea of endothelial dysfunction as a condition characterized by an imbalance of mediators that normally ensure the optimal course of endothelium-dependent processes has been formed. Due to the proven role of the development of endothelial dysfunction in the pathogenesis of diseases of the cardiovascular, respiratory systems, metabolic disorders, etc. Endothelin-1 (ET-1) can be used as such a prognostic and diagnostic marker of endothelial dysfunction. Purpose of the study: analysis and synthesis of literature data using WoS, Scopus, RSCI databases. Based on clinical and experimental data, it can be concluded that the use of markers of endothelial dysfunction, including the level of endothelin-1 in blood serum, can be used to assess the severity of socially significant diseases when they manifest in childhood and adolescence.

COVID-19 is at high risk for complications such as acute myocardial injury, kidney failure, or thromboembolic complications. The consequences and manifestations of the post-covid syndrome are different. To date, the pathogenesis of the disease caused by this virus (COVID-19) remains unclear, while there is more and more data confirming the important role of microcirculation disorders in the development of this disease, which are supposed to be systemic. These can be newly appeared symptoms of the acute stage of coronavirus infection, as well as new ones.
The article presents clinical cases of thrombotic complications in children after suffering COVID- 19, obtained on the basis of the Department of Pediatric Cardiorheumatology of the National Center for Maternal and Child Welfare. The report reflects the options for thrombotic complications after a
new coronavirus infection in children with congenital heart defects, as well as cases of thrombosis of the veins of the extremities and cerebral vessels. infection, as well as early detection of initial signs of such complications.

Target. To study the availability of dental institutions in Sughd and Khatlon regions, pediatric dentists. Material and methods. The work is based on the analysis of the reporting form 17, approved by the order of the Agency for Statistics under the President of the Republic of Tajikistan No. 054 dated October 11, 2013. Data for the period from 2017 to 2021 were analyzed. Results. The total number of doctors serving children - a pediatric dentist in Khatlon region for five years was 82 (5.3%), in Sughd 156 doctors, the differences are statistically significant (p<0.001). In Sughd region in 2021 the indicator of provision with pediatric dentists is 0.237 per 10 thousand children. while in the Khatlon region it is more than 2 times lower - 0.106 per 10 thousand children. Conclusions. With a smaller number of children in the Sughd region, at the same time, the number of pediatric dentists is 2 times higher compared to the Khatlon region. The provision of pediatric dentists in Khatlon region is more than 10 times lower than in the country and 2 times lower than in Sughd region.

To date, bronchial asthma continues to be one of the most frequent chronic non-communicable diseases of the respiratory system, which in turn makes it a global problem of the health system. Modern international and national guidelines for the management of children with bronchial asthma highlight the significant role of respiratory infections in the pathogenetic mechanisms of the disease. Respiratory infections determine the phenotypic realization of bronchial asthma and serve as the most frequent trigger of its exacerbation in children and adolescents. The impact of viruses on the mucous membrane of the bronchial tree, colonization by bacteria leads to its microbial damage and inflammation, thereby facilitating the penetration of allergens and, as a consequence, the risk of exacerbation of bronchial asthma.
The systematic review of the literature presented by us indicates the effectiveness of the use of active immunization of patients with bronchial asthma. The use of vaccines to prevent or attach respiratory tract infections in children and adolescents with bronchial asthma in combination with traditional therapies leads to a decrease in the number of hospitalizations, an improvement in the level of control over the symptoms of the disease and an improvement in the quality of life.

Target: to study the possibilities of organizing the feeding of newborns with anomalies in the development of the central nervous system before and after the operation.
Materials and methods. The work is based on a retrospective analysis of 25 case histories of full-term patients with congenital hydrocephalus who underwent surgery in the period from 2016 to 2020.
Results. The duration of the preoperative period in 22 (88%) patients ranged from 6 to 15 days (±2.5–13.3). All children were on enteral nutrition throughout the entire time, 14 (56%) combined with parenteral nutrition, 21 (84%) children received breast milk, of which 90.4% needed additional feeding with an adapted mixture. The basis of parenteral nutrition was the use of carbohydrates in 48% of children, in combination with protein in 5 (20%) children. Bulbar disorders were attributed to the main reasons for the decrease in the volume of enteral nutrition. To assess the sufficient supply of energy, the corresponding calculation of the daily caloric intake was carried out. It was taken into account that the calculated kilocalories could be provided both with enteral and parenteral feeding. Brain damage is a fairly specific process. Which require the need for an individual approach to solving issues related to the organization of the feeding process. It was found that a significant part of children (64%) had access to 100% of the calculated calorie intake on the day preceding the operation, which corresponds to the standard indicators. However, 28% of children were provided with 55 to 75% of the calculated kilo-calories, and 12% of children only 50% or less.
Conclusions. Enteral nutrition using breast milk for children with congenital malformations of the ventricular system of the central nervous system at the pre- and post-operative stage improves the survival of children. The use of enteral nutrition in the required volumes provides the child with energy and protein.

Target: assess the consequences of prenatal fetal hypoxia. Materials and methods. The work is based on the analysis of statistical accounting form 32 "Health status of pregnant women in childbirth and newborns" for the period from 2017 to 2021. approved by the order of the Agency on Statistics under the President of the Republic of Tajikistan No. 054 dated October 11, 2013.
Results and discussions. In Tajikistan, the number of live births ranges from 229,183 in 2017 to 231,018 in 2021, the dynamics for 5 years was +1835 cases, the T/inc. + 0.79%. Of the children born sick or ill in the perinatal period, 9038 (7.5%) died before the end of the neonatal period. The dynamics of this indicator for 5 years had a positive character +117 cases, the indicator Т/appr. +6.5%. Within 5 years, the number of stillbirths was 12284 cases, over the past 5 years, the number of stillbirths decreased by -162 cases, the indicator T / inc. also had a negative trend - 6.0%.
Conclusions. It was determined that within five years the number of children born sick or sick increased by 7428 (+3.2%) cases. With an increase in the absolute number of dead children in the NP by 117 cases, a decrease in the T / appr. by 22.2%. The absolute number of fetuses who died in the intranatal period increased by 111 cases, T/app. increased by +22.0%.

The aim is to determine the impact of non-conventional factors on adherence to therapy, the level of control of bronchial asthma in children and their quality of life. Materials and methods. The study included 147 children aged 13-17 with asthma and their mothers. The Russian- language versions of the questionnaires on situational and personal anxiety, quality of life, the level of disease control and adherence to it, the author's questionnaire on the level of knowledge about asthma were used. Results. Adherence to treatment, its effectiveness and quality of life depend on the level of anxiety and knowledge about bronchial asthma of the patient and his mother. A high level of personal, situational anxiety and insufficient knowledge of the child and his mother about bronchial asthma determine the low level of their adherence to basic treatment. This negatively affects the level of control over the disease and the quality of life of a sick child. A negative impact on the level of smoking control in the family and unfavorable living conditions has been established. Passive smoking and poor living conditions - the absence of a separate room for a sick child, uncomfortable housing, allergenic life, determine the low level of control over bronchial asthma.

The purpose of the work. To study the effect of the disease and treatment on headache in patients with vestibular schwannoma and to identify clinical predictors of long-term disability in headache.
Methods. A cross-observational study was conducted. The cohort included patients with primary vestibular schwannoma < 3 cm and a separate group of individuals from the general population of the control group without tumors. The study included a survey using a questionnaire of disability due to headache, hospital anxiety, depression scale and a questionnaire of symptoms of vestibular schwannoma.
Results. The data of 538 patients with vestibular schwannoma were studied. The average age of patients was 65 years, 57% of patients were women, the average interval between treatment and examination was 7.7 years. Twenty-seven percent of patients underwent microneurosurgery, 29% - observation. Patients with vestibular schwannoma who were under observation were more than twice as likely to suffer from severe headache compared to 103 control subjects without vestibular schwannoma.
Conclusion. On average, almost 8 years after treatment, about half of patients with vestibular schwannoma experience headaches of varying frequency and severity. Patient-dependent factors, including age, gender, mental health, and pre-existing headache syndrome are the strongest predictor of prolonged severe disability in headache.

The article presents the primary results of a randomized study of surgical treatment of the proximal femur in 119 elderly and senile patients studied in the traumatology department of the Clinical Hospital of Emergency Medical services
(CHEMS) of the Bishkek Scientific Research Center of Traumatology and Orthopedics (BSRCTO) since 2019. The following indicators are currently being considered: information methods for accurate topical diagnosis of fracture limitation and morphology - clearly distinguished by the AO/ASIF classification, limitation and morphology of the fracture, which plays an important role in the operating surgeon’s choice of fixation method and directly affects the results of treatment and the patient’s age. According to the WHO classification, according to the age of patients, there were twice as many cases in elderly people than in elderly people. This is due to the emergence of osteoporosis among older age groups of people, with the improvement of life and a sharp increase in the number of older people. Therefore, clinical diagnosis is a prerequisite for correct treatment, and the diagnosis should always be made through a comprehensive general examination of the patient. The development of modern medical technologies brings traumatology and orthopedics into orbit and contributes to the emergence of new methods of work for surgeons.

The purpose of the study in this scientific article was to compare the results of microbiological examination of the contents of dental cavities and the periodontal junction before and after treatment. A microbiological study was carried out on 93 people aged from 20 to 65 years. Smears for the study of qualitative and quantitative analysis of the microbiota were taken from the dental cavity for the diagnosis of caries, pulpitis and periodontitis, and for periodontal diseases - from the dentogingival junction. All smears were examined at the State Sanitary and Epidemiological Surveillance Center in Bishkek and at the Aqualab laboratory. As a result of the work, an analysis of the microbiota of the oral cavity was given, which showed that the species composition and number of microorganisms changed significantly before and after treatment. Before treatment, 12 types of microorganisms were isolated with a seeding density of 104 - 105 CFU, which indicates the need for timely sanitation of the oral cavity. After treatment, the species composition indicators decreased - 3 types of microorganisms and the number of microorganisms was 102-103 CFU. The findings of the study show that timely sanitation of the oral cavity, drug treatment and restoration of microflora directly affect the species composition and number of microorganisms.

Despite significant advances in the rehabilitation of patients with midfacial defects and deformities, there is still controversy regarding the preferred treatment methods. To facilitate understanding of the scope and complexity of the defect and the choice of treatment, various classification systems have been proposed, each reflecting different practical approaches to the problem, but most have not been widely used.
The article describes the classification of postoperative defects and deformations of the middle zone of the face on the basis of clinical, functional studies and long-term clinical experience. The classifications proposed by the authors allow us to structure defects after any volume of resection of the middle zone of the face, allows us to reliably make a clinical diagnosis, determine the characteristic features of the defect in order to select the necessary prosthesis structures for full anatomical and functional restoration of the lost area and cosmetic rehabilitation of the appearance of the face.

The human olfactory analyzer is one of the body’s complex sensory systems, which allows one to recognize, analyze and identify odors in the environment. In addition, the sense of smell plays an important role in human eating behavior (it influences appetite, gives taste to ingested food, sends impulses to the cerebral cortex to stimulate the production of food enzymes) and is involved in establishing sympathy between people. It is believed that smell evokes emotions at a deep level that is not always conscious to a person. There are a number of diseases leading to a decrease and/or distortion of the sense of smell. In recent years, due to the outbreak of coronavirus infection, the frequency of damage to the olfactory analyzer has increased significantly. Currently, any of the symptoms of impaired sense of smell should alert you to the first signs of coronavirus infection, as it is one of the leading symptoms. As a consequence, there is a need for early diagnosis of pathologies of the olfactory analyzer, which increases the importance of olfactometry. We have studied and tested available olfactometric techniques. While studying this issue, we came to the conclusion that the proposed methods do not fully meet our requirements. In this connection, we proposed a modification of the method. This article describes the methodology for carrying out the olfactory set we have selected.

This article examines the role of women in the public life of our country during the period of tradition and modernity. Changes in the role and status of women in Kyrgyz society are determined, the conditions for compliance with the principles of gender equality and the participation of modern women in solving political and economic problems of society are revealed. The activities of women artisans in implementing the goals of the Sustainable Development Strategy adopted by the UN and the National Development Strategy of the Kyrgyz Republic for 2018–2040 are highlighted.
The goals of promoting women at all levels of political power in Kyrgyzstan are reflected. The reasons for the need for women's participation in power structures are identified in order to solve not only political, but also social, cultural and moral problems of modern Kyrgyz society.

In our daily lives and as our knowledge grows, it's clear that paying attention to how we speak is crucial. People are putting effort into studying speech- related topics, teaching good speech habits in schools, and making other attempts to improve speech culture. This article shares some basics about speech culture, the connection between language and speech, how they work together, and why communication is so vital in shaping good speaking habits. Learning how to speak well is closely tied to how we think, and they both influence each other. Teaching people how to communicate effectively is really important in today's world. The different ways we speak, write, and express ourselves are connected to how our culture is developing. This has a big impact on how people develop their overall understanding and manners.