Vol. 5 No. 5 (2024): EUROASIAN HEALTH JOURNAL

The state and prospects for the development of medical education in our country remain an important topic for discussion, especially in the context of rapidly developing technologies and innovations in medicine. Modern medical personnel must have not only basic knowledge, but also be able to apply advanced diagnostic and treatment methods, use high-tech equipment, and work effectively in the context of digitalization of healthcare. This requires regular updating of educational programs and competencies, especially at the postgraduate level. Retraining and advanced training of specialists should take into account the latest advances in medicine, as well as the introduction of new educational technologies, such as simulation trainers and online courses. It is important that medical training programmes reflect current healthcare needs, promoting the development of an interdisciplinary approach and improving the quality of medical services in the country. Objective: to analyze the current situation and development opportunities of postgraduate education in the Kyrgyz Republic. Research methods. This article is devoted to a review of the literature on the problems of development at the postgraduate level of education, where the main directions of medical education, the study of foreign experience, based on the analyzed literature are considered. This study describes the state and prospects for the development of medical education in Kyrgyzstan, using a diverse set of methods, including: thematic research methodology and comparative method.

In the Kyrgyz Republic for the entire period as of 12/31/2023, 13 289 people were living with HIV infection. Testing, treatment, and viral load suppression cascades are 70 - 79 - 90. Treatment approaches and low immune status affect the survival rate of PLHIV receiving ART. The purpose of this study is to conduct a survival analysis in HIV-infected patients on ART as well as to evaluate the efficacy of the treatment depending on gender. Data of 13 289 registered cases in the Kyrgyz Republic among patients of 18 years and older on ART was processed. An analysis of viral loads, the level of CD4 and death rates was carried out at different periods of duration of ART. The duration of ART influences survival rates positively, the latter being higher in women. Women achieve virological effectiveness at the start of ART faster than men. Virological and immunological effectiveness among women on ART is higher than among men. Timely initiated ART increases survival rates, especially among women.

The purpose of the study: to study the clinical and laboratory features of the course of chronic viral hepatitis B (HVB) in elderly patients in the Kyrgyz Republic. Material and methods. The case histories of 200 patients with HVB were analyzed (95 men (47.5%) and 105 women (52.5%), aged 28 to 75 years (average age – 55 years). All the studied patients with HVB were divided into 2 groups: group 1 (main group) consisted of 100 elderly patients (over 60 years old), group 2 included 100 patients under the age of 60 (control group). In addition to general clinical and standard laboratory examinations, all subjects underwent enzyme immunoassay (ELISA) for markers of viral hepatitis B, C, D, polymerase chain reaction (PCR) (qualitative and quantitative PCR) for markers of viral replication with an assessment of viral load, as well as liver fibroelastometry to verify the stage of fibrosis. Statistical processing of the obtained data was carried out using the STATISTICA 10.0 program. Results. In elderly patients, CHB in most cases occurs due to co-infection with the delta agent (67%). The main route of infection is through surgical interventions (including dental) (47%). There is a high frequency of comorbidity due to the frequency of combination with hypertension (38%) and CKD (16%) with increased levels of creatinine and residual nitrogen. Conclusion: among elderly patients with CHBV, the clinical picture is dominated by dyspeptic icteric and cholestatic syndromes with increased alkaline phosphatase, and advanced stages of liver fibrosis are more often detected.

Life expectancy has increased significantly in recent decades. In this scenario, healthcare interventions are needed to improve the prognosis and quality of life of older adults with cardiovascular risk factors and cardiovascular disease. However, the number of older patients included in clinical trials is small, so current clinical practice guidelines do not include specific recommendations. The aim of this document is to review preventive recommendations targeting
patients ≥ 75 years old with high or very high cardiovascular risk regarding goals, medical treatment options, and including physical exercise and its inclusion in cardiac rehabilitation programs. In addition, it is shown why geriatric syndromes such as frailty, dependence, cognitive impairment and nutritional status, as well as comorbidities, should be considered in this population in terms of their important prognostic impact. It is important to assess the most common comorbidities, including anemia, which is often identified in older age, and the mental status of patients, as depression iscommon in this population and may be confused with or overlap with cognitive impairment, increasing complications and cardiovascular morbidity and mortality.

The evolution of cognitive impairment of vascular origin is becoming an increasingly prominent health threat, especially in this era when hypertension is a leading contributor to the global burden of disease and overall health loss. Hypertension is associated with altered cerebral microcirculation coupled with adverse vascular remodeling, with subsequent slowing of mental processing speed, reduced abstract thinking, loss of language abilities, and deficits in attention and memory. Due to the rapidly increasing burden of hypertension in Kyrgyzstan, we assessed the prevalence and correlates of cognitive impairment among hypertensive patients admitted to the Bishkek Clinical Multidisciplinary Hospital No. 1. The present study highlights that cognitive decline is significantly prevalent among individuals with systemic hypertension. More than two-fifths of the hypertensive participants in this present study had cognitive impairment. There is a wide variability in the prevalence of cognitive impairment (16.5–63.9%) among hypertensive individuals in the literature, but our rate is in the middle. This discrepancy in prevalence may result from differences in population characteristics and variability in the instruments used to assess cognitive function across studies. It is therefore imperative to include cognitive assessment in the routine evaluation of hypertensive patients.

Acute appendicitis ranks first among urgent abdominal diseases and accounts for 70% of all operated patients. Diagnostic errors in diagnosing acute appendicitis occur in 12-31% of cases, and at the pre-hospital stage (primary health care) this figure reaches 70%. To improve diagnostics, many research scales have been developed, they are simple and non-invasive. Objective of the study: Improving the diagnostics of acute appendicitis in the elderly using various diagnostic scales.
Materials and methods. During the study, all clinical signs were prospectively determined according to the criteria of the scales used in the diagnosis of acute appendicitis, and laboratory tests were performed in all elderly and senile patients with suspected acute appendicitis. The total number of patients was 252 patients. A retrospective study of the case histories of 82 patients who were diagnosed with acute appendicitis and who underwent surgical treatment was conducted. Results. As a result of the study, the coincidence of the criteria of the scales used in the diagnosis of acute appendicitis is at different levels - from 81.7 to 93.9 percent. Conclusion. The RIPAS scale is a useful indicator for the diagnosis of acute appendicitis in elderly and senile people.

Purpose of the work: to develop surgical tactics for prevention of purulent-septic complications in the area of colorectal anastomosis based on the analysis of immediate results of laparoscopic anterior low and ultra-low rectal resections. Material and methods: the results of surgical treatment of 8 patients who underwent laparoscopic anterior rectal resection with low and ultra-low formation of colorectal anastomosis were analyzed. There were 5 mens (62.5%), 3 women (37.5%). The average age of patients was 62 years (37-76 years). Stage III rectal cancer was established in 5 (62.5%) patients, stage II – in 2 (25%) and stage I – in 1 (12.5%). Rectal cancer localization: lower ampullary region – 1 (12.5%), middle ampullary region – 3 (37.5%), upper ampullary region – 2 (25%), rectosigmoid region – 2 (25%). Histomorphological picture of the macropreparation: adenocarcinoma of varying degrees of differentiation. Results and discussion: all patients were discharged from the hospital without fatal outcomes. The average duration of hospitalstay was 12 bed-days (10-17 days). In 3 patients (37.5%), colorectal anastomosis suture failure developed on days 3-5 of the postoperative period. Two patients were re-operated (1 – laparotomy,
colostomy, 1 – laparotomy, extraperitonization and extraperitoneal drainage of the anastomosis area). Conclusions: surgical treatment of operable rectal cancer is preferably performed laparoscopically. The incidence of colorectal anastomosis failure increases with low tumor localization. The methodology of laparoscopic anterior rectal resection suggests performing the following stages of the operation: application of a preventive colostomy, extraperitonization of the colorectal anastomosis by suturing the pelvic peritoneum, drainage of the anastomosis zone with an extraperitoneal drainage in the left iliac region.

Bariatric and metabolic surgery is one of the most effective methods of treating morbid obesity and associated diseases such as type 2 diabetes, hypertension and dyslipidemia in the modern world. As the number of overweight and obese people continues to grow worldwide, the need for bariatric surgeries also increases. Despite the high efficiency of bariatric surgery in the short term, the problem of postoperative weight regain remains a serious challenge, reducing long-term treatment results and increasing the risk of recurrence of associated diseases. Among the existing methods of preventing weight regain, there is increased malabsorption or increased restriction by using primary bandaging together with the main surgery. As a promising solution, a method of one anastomosis gastric bypass with modified fundoplication (FundoRing) is proposed, which combines the advantages of increased restriction and antireflux effect. This may help prevent weight regain and improve metabolic outcomes, reducing the risk of band-related complications and malabsorption syndrome. However, further randomized studies with long-term follow-up are needed to confirm the efficacy and safety of this technique. Thus, the FundoRing technique represents a promising alternative to traditional methods and may be a significant step in in the struggle against the obesity epidemic and its consequences.

Objective. Maintaining hearing after surgery to remove vestibular schwannoma remains a difficult surgical task. In some patients with preserved inner ear function, hearing improvement is achievable. Since it is currently impossible to determine which patients will have such a result, forecasts should be based on previously published reports. In our clinical case, we describe a patient whose hearing improved from a minor level to a useful one after surgery to remove a vestibular schwannoma.
Methods. The operation was performed by suboccipital retrosigmoid access. The patient underwent a basic audiovisual protocol before and after surgery: audiometry of pure tone and speech, otoacoustic emission, auditory reactions of the brain stem, electronystagmography, as well as a detailed questionnaire. The usefulness of hearing was assessed using international recommendations supplemented by a frequency of 4 kHz.
Results. Hearing was preserved and even improved from a useless level to a useful one. Based on the available literature, the most informative factors predicting such a result seem to be: sudden sensorineural hearing loss before surgery, pronounced otoacoustic emission and damage to the upper vestibular nerve.
Conclusion. There is a limited amount of research on this topic, and it is still impossible to regularly improve hearing in properly selected patients. In addition, the importance of postoperative hearing quality compared to other symptoms and complications remains controversial.

Traumatic brain injury (TBI) is one of the most important causes of death in patients under the age of 25 and is responsible for one third of all injury-related deaths. Therefore, knowledge of the epidemiological picture of this injury in different populations is vital. Thus, the purpose of this study is to study the epidemiological picture of TBI in emergency departments. Methods. In this cross- sectional study, the profiles of 1,000 victims were analyzed. Patients with TBI were selected using a simple random sample. This study looked at variables such as demographic data, time of year, mechanism of injury, concomitant injuries, level of consciousness, duration of hospitalization, computed tomography (CT) results, need for surgery, admission to the intensive care unit, and patient outcome. As a result, independent risk factors for patient death were identified. Results. 1000 patients suffering from (81.8% of men; average age 38.5±21.7 years) were examined. The frequency of their visits to the hospital in the spring (31.4%) was higher (p<0.01). In 45.9% of patients, the level ofconsciousness was below 9 points on the Glasgow Coma Scale (GCS). Subdural (45.9%) and epidural bleeding (23.7%) were the most frequent CT scan results in this study (p<0.001). As a result, 233 (23.3%) patients died. Independent risk factors for death in TBI were age over 60, falls and motorcycle accidents, intracranial hemorrhage accompanied by brain contusion, subdural bleeding, BCC less than 9 and the need for hospitalization in the intensive care unit. Conclusion. Age over 60 years, falls and motorcycle accidents, intracranial hemorrhage accompanied by brain contusion, subdural bleeding, BCC less than 9 and the need forhospitalization in the intensive care unit were independent risk factors for death in patients with TBI. 

Forty consecutive patients who underwent cranial trepanation for traumatic hematoma after developing bilateral fixed dilated pupils were studied to determine factors affecting the quality of survival and to search for management criteria. Clinical data and computed tomography (CT) data correlated with the outcome 1 year after craniotomy. The functional recovery rate (good result or moderate disability) was 25%, and the mortality rate was 43%. Material and methods. Patients with subdural hematoma had a higher mortality rate (64%) compared to patients with epidural hematoma (18%) (chi-squared criterion, p > 0.05). Other factors associated with markedly increased morbidity and mortality were an increase in age (> 20 years), a long interval (> 3 hours) between loss of pupil reactivity and cranial trepanation, compression of basal cisterns and the presence of subarachnoid hemorrhage on computed tomography. Results. Among the patients who had any of the following symptoms, there were no survivors: surgery 6 hours or more after bilateral loss of pupil reactivity;
age over 65 years; or lack of motor reaction. The results obtained indicate that the presence of an acute subdural hematoma is the single most important predictor of a negative outcome in patients with bilateral unresponsive pupils.

Intracerebral hemorrhage (ICH) is the most devastating and disabling type of stroke. Uncontrolled arterial hypertension (AH) is the most common cause of spontaneous ICH. Recent advances in neuroimaging, organized stroke treatment, specialized neuro-intensive care, medication and surgical treatment have improved the management of patients with ICH. Timely respiratory tract protection, control of malignant hypertension, urgent treatment of coagulopathy and surgical intervention can increase the chances of survival in patients with severe ICH. Two recent randomized trials have proven the safety of intensive reduction of systolic blood pressure to <140 mmHg. Platelet transfusion in patients receiving antiplatelet therapy is not indicated unless the patient has planned surgical removal of a hematoma. In patients with a small hematoma without a significant increase in volume, there is no indication for the routine use of mannitol or hypertensive saline solution (HSS). However, for patients with large intracerebral bleeding (volume > 30 cubic centimeters) or symptomatic perihematomic edema, it may be useful to maintain serum sodium levels at 140-150 meq/L for 7-10 days to minimize the expansion of edema and mass effect. Mannitol and HSS can be used in emergency cases with exacerbation of cerebral edema, increased intracranial pressure (ICP) or in the event of a hernia. HSS should be administered through the central channel as a continuous infusion (3%) or bolus (23.4%). Ventriculostomy is indicated in patients with severe intraventricular hemorrhage, hydrocephalus or elevated ICP. Emergency evacuation of a hematoma may be useful for patients with large cerebellar or temporal hematoma.

Arnold-Chiari syndrome is a rare congenital disease characterized by a decrease in the volume of the cranial cavity and a change in the anatomy of the posterior cranial fossa. Arnold-Chiari syndrome has several types (from 1 to 4), each of which is characterized by a different degree of compression of the brain and hydrocephalus, and its new forms have recently been added (type 0 and 1.5). the quality of life of patients. The disease is most common in children and young people. According to experts, its prevalence ranges from 3.2 to 8.4 cases per 100,000 people worldwide. The incidence and severity of Arnold -  Chiari syndrome have a statistically significant tendency to increase in the female sex. The etiology of Arnold-Chiari syndrome has not yet been fully studied, but it is assumed that genetic factors and effects on the fetus during pregnancy may play a dominant role in its development. Clinically, the syndrome is manifested by headache, vomiting, swallowing disorders, various motor disorders, impaired coordination and long-lasting Babinsky reflex, weakness and numbness in the extremities, sleep problems and other symptoms. Patients may also develop hydrocephalus, which increases the risk of serious complications and requires surgical interventions. The article presents data on the prevalence, clinical manifestations and treatment of Arnold-Chiari syndrome, as well as our own clinical observation of the course of this disease, which is combined with dextrocardia and heterotaxia – the mirror position of internal organs in a 10-year-old patient. Arnold-Chiari syndrome today refers to severe congenital diseases of the nervous system that are difficult to diagnose at an early age, therefore it is important for a pediatrician to understand the mechanism of occurrence of this disease in order to be able not only to eliminate, but also to prevent the undesirable consequences of this disease. 

This article presents a clinical case of a congenital developmental disorder in the form of "Ectodermal Dysplasia" in combination with other congenital anomalies. Ectodermal dysplasia is a group of congenital diseases characterized by abnormalities in the development of tissues derived from the ectoderm, such as skin, hair, nails, and teeth. Diagnosing this condition requires genetic analysis and consideration of several criteria based on clinical manifestations and available investigations. The article discusses clinical and anamnesis data, laboratory results, instrumental findings, and social aspects. Special attention is given to a detailed description, including photographs, of a 2-year-old girl diagnosed with ectodermal dysplasia in conjunction with other congenital malformations affecting the central nervous, cardiovascular, musculoskeletal, and urinary systems. The analysis of this case not only helps to systematize existing knowledge about the condition but also provides insights into its interaction with other pathologies. Thus, the article highlights the importance of a comprehensive approach to diagnosing ectodermal dysplasia, emphasizing the need for early detection and individualized care for each patient to ensure effective support.

Epidemiological studies of the prevalence of allergic diseases in children in the Kyrgyz Republic (Bishkek, Jalal-Abad, Balykchy) carried out in accordance with international standards under the program “International Study of Asthma and Allergy in Childhood - ISAAC”, allowed to obtain data comparable with the results of similar studies in the world. However, today these data need to be updated by organizing regular epidemiological studies in accordance with the IV phase of ISAAC. To date, new ISAAC centers in the cities of Naryn, Balykchy, Osh, and Jalal-Abad have undergone international registration in Auckland (New Zealand). Children with a history of atopy living in different climatic, geographical and environmental areas should be actively questioned through the ISAAC program for early detection of allergy symptoms. It is advisable to more widely introduce the ISAAC program questionnaire into the list of mandatory medical documentation of primary health care physicians for the early detection of allergies among children. In order to determine the spectrum of sensitization in allergic diseases in children, we analyze the results of modern molecular allergy testing ALEX. Data on the prevalence of allergic pathology among thechild population of the Kyrgyz Republic allow us to develop a set of measures to improve the organization of allergological care for children and adolescents.

This article is dedicated to the study of the little-known plant Alfredia nivea, which grows in the Kyrgyz Republic and possesses nootropic properties. The relevance of this topic is determined by the growing problem of diseases manifested by impairments in cognitive and mnemonic functions. In modern conditions, the task of studying and developing effective pharmacotherapy for nervous and mental disorders becomes especially important, as these issues have high social significance. Nootropic drugs play an irreplaceable role in the correction of higher nervous activity disorders associated with a wide range of diseases related to central nervous system damage. Currently, one of the key directions in healthcare is the expansion of the range of medicinal products through the introduction of new drugs based on plant phytosubstances, particularly those with nootropic effects. The aim of the study is to investigate this plant material. The materials of the study included flowers, stems, leaves, and roots with rhizomes of Alfredia nivea, collected during the flowering period. Botanical and geobotanical methods were used for analysis. The study of the distribution and ecology of Alfredia nivea is a promising direction in pharmaceutical research, as its distribution in the Kyrgyz Republic opens opportunities for the creation of new phytosubstances, which can significantly improve approaches to the treatment of cognitive disorders. As a result of prolonged searches, this medicinal plant material was found in the Chui region, in the Kemin district, in the village of Ak-Tyuz. Conclusion: The conducted research successfully established the distribution range of Alfredia nivea and described its ecological characteristics. This study not only expands the understanding of this species but also lays the groundwork for future research related to the effects of its active components with nootropic properties.

This study is devoted to the treatment of 90 patients with injuries of the acromioclavicular joint types III-V in accordance with the Rockwood classification, aged from 18 to 70 years. treated at city hospital No. 1 in Shymkent, South Kazakhstan region of the Republic of Kazakhstan from 2020 to 2023. 40 (45.5%) patients made up the main group who received complex treatment of patients, including a new combined method of restoring the acromioclavicular joint. The control group included 50 (55.5%) patients in whose treatment the traditional method was used: the clavicle was fixed with a hook-shaped plate without restoring the acromioclavicular joint ligaments. At the same time, the frequency of excellent and good treatment results was obtained by 1.7 and 1.2 times, respectively, and the frequency of satisfactory results was reduced by 4.8 and unsatisfactory results by 4.7 times compared to the traditional method of treatment, which confirms the effectiveness of the developed treatment tactics for patients.

From 2021 to 2024, the Department of Orthopedics at the Kyrgyz Research Institute of Balneology and Rehabilitation performed surgical treatment on 120 patients with degenerative diseases of the lumbar spine. Postoperatively, 42.6% of patients experienced complete pain relief, with the achieved effect persisting in the long-term follow-up. Significantly severe pain persisted in 3.3% of patients. The study showed that modern surgical methods, including anterior spondylodesis and microdiscectomy, improve substantially treatment outcomes compared to traditional methods. Early rehabilitation using individual programs facilitates rapid patient recovery. The introduction of anterior stabilizing implants made from porous nickel-titanium significantly improved spinal stability and reduced recurrence risk. A comprehensive approach, including surgical intervention, medication therapy, and rehabilitation programs, has shown high effectiveness. Medical rehabilitation, utilizing therapeutic physical training and other physiotherapy methods, played a key role in strengthening muscles and reducing pain syndrome. However, the necessity for further research and improving treatment methods remains relevant for enhancing outcomes in complex cases.

Edema of the optic disc with increased intracranial pressure was first described in 1853. Since then, there have been many contradictory hypotheses explaining its pathogenesis. The purpose of this work was to investigate the basics of the pathogenesis of optic disc edema, to verify the validity of previous theories and, finally, on the basis of all these studies, to find a logical explanation for the mechanisms of pathogenesis. The studies included the following issues related to the pathogenesis of optic disc edema with increased intracranial pressure: anatomy and blood supply of the optic nerve, the role of the optic nerve sheath, centripetal fluid flow along the optic nerve, compression of the central retinal vein and acute intracranial hypertension and related consequences. A sharp increase in intracranial pressure was not accompanied by a rapid onset of edema of the optic disc. Then, the scientists managed to experimentally induce chronic intracranial hypertension by slowly increasing the size of volumetric lesions in different parts of the brain. It was found that edema of the optic disc was observed in patients with increased pressure of cerebrospinal fluid.

One of the main problems faced by otolaryngology and surdology is cochlear neuritis. This circumstance is due to the importance of the auditory function, which helps to ensure not only physical, but also social and spiritual well-being of a person. Overcoming problems associated with hearing impairments goes beyond individual specialties and is one of the most important tasks of all practical medicine. Hearing problems are present in 4-6% of the world's population. Hearing impairments are present in 14% of people aged 45-64 years and in 30% of people over 65 years. According to the World Health Organization (WHO) for 2024, more than 5% of the global population, which is 430 million people (including 34 million children), need rehabilitation due to disabling hearing loss. It is predicted that by 2050 this figure may grow to more than 700 million people, which will be about 10% of the total population. Similar trends are observed in other countries with developed social infrastructure.
For the Kyrgyz Republic, as well as for other CIS countries, the problem is aggravated by the fact that, due to certain economic and socio-political changes, there has been a significant increase in the prevalence of hearing impairment due to the emergence of a new infection - Covid-19, which has led to an increase in the number of patients with inner ear pathology , resulting in a deterioration in the quality of life, disability, and disruption of social adaptation of patients of this profile. In this regard, epidemiological research methods are of paramount importance in the primary prevention of hearing impairment. It is on the basis of the results of such studies that it is possible to develop standards in the diagnosis, treatment and prevention of this common disease.

The article presents the results of an analysis of the research conducted between the incidence among residents of the city of Bishkek and indicators of atmospheric air pollution. Data on atmospheric air pollution were obtained from reports of the State Agency for Hydrometeorology (Kyrgyzhydromet), the Ministry of Emergency Situations of the Kyrgyz Republic, and the Ministry of Natural Resources, Ecology and Technical Supervision. The analysis of morbidity was carried out according to the reports of the National Statistical Committee of the Kyrgyz Republic for 2015 and 2019. According to regular observations, for the period 2015–2021. average annual concentrations of nitrogen dioxide in the city of Bishkek exceeded the maximum permissible concentrations from 1.2 to 1.5 times; formaldehyde – from 2.3 to 3.7 times; particles less than 10 micrometers in size by 3 times, particles less than 2.5 micrometers in size (PM2.5) - 1.4 times. The growth of tumors may be associated with the content of formaldehyde and benzopyrene-3,4 in the air, which are carcinogens. An increase in respiratory morbidity by 32.8% is associated with exposure to nitrogen oxides, which, when combined with water vapor, form nitric acid, which destroys lung tissue, leading to chronic lung diseases. The increase in neoplasms and congenital anomalies (43%) is of particular concern, especially since there are no nuclear power plants or industrial enterprises in the city.

The article reveals the modern aspects of smoking and electronic cigarettes, popular among young people today, their impact and harm to health. A significant part of the work was the analysis of smoking among young people and students. The prevalence of smoking among the population is described. The article analyzes questionnaire reports received in the form of questions and answers from residents aged 14-31 years among young people. 126 people from different age groups (14-31 years) took part in the questionnaire survey. 76 students (14-15 years old) took part in the oral survey. Of these, 51% are men and 49% are women. By age, 16% are 14-18 years old, 69% are 19-23 years old, 12% are 24-30 years old and 3% are over 30 years old.
Purpose of work. Epidemiology of smoking among the population, including youth, and the study of their prevalence among young people (14-31 years). The research was conducted among residents and students of Bishkek
The materials of the study include questionnaire statistics conducted among schoolchildren and youth aged 14-31. The survey was conducted in Bishkek in 2023.
The results of an open question and answer among schoolchildren are as follows: 18% have never smoked, 25% have smoked and still smoke, 57% have. Almost 82% of teenagers and schoolchildren try cigarettes during their school years and 25% start smoking since then.

This study examines cultural and linguistic nuances of the concept "respect/urmat- syi/respect" in medical texts, comparing examples from Kyrgyz, Russian and English languages. The concept "respect/urmat-syy/respect" plays an important role in doctor-patient communication and affects the quality of medical care. In a multicultural environment where people of different linguistic and cultural backgrounds meet, it becomes increasingly important to understand the subtle differences in the meaning and application of this term. This article analyses how 'respect/urmat-say/respect' is expressed in medical texts and documents in the three languages mentioned and what cultural implications result from this. Through detailed analyses of selected medical texts, differences and similarities will be identified, indicating the cultural values and norms of the respective language communities. This study helps to deepen understanding of the importance of respect in medical communication and highlights the importance of recognising linguistic and cultural differences in medical practice. The findings offer valuable insights for medical practitioners, translators and ethicists working in international and multicultural settings.

This topic combines modern trends in education, such as the emphasis on interactive learning and the use of modern technologies, with the need to compile specialized educational material - a Latin-Kyrgyz educational dictionary. It is important to consider the needs of medical students who use Latin terms in their future medical practice. Such an educational dictionary should combine the linguistic aspects of the Latin language with clinical examples and modern educational methods for effective assimilation of the material. In modern medical education, special attention is paid not only to clinical skills and theoretical knowledge, but also to the in-depth study of the Latin language, the basics of medical terminology. The development of a modern Latin-Kyrgyz educational
dictionary for medical students is becoming a key element of this educational process, combining traditional teaching methods with innovative approaches.