Vol. 2 No. 2 (2025): EUROASIAN HEALTH JOURNAL

Cases of foodborne botulism are reported annually in the Kyrgyz Republic in the form of sporadic and group outbreaks. Botulism is a rare infectious disease and due to the specific clinical picture, presents great difficulties for clinicians to diagnosis. The aim of the study was to investigate the epidemiological and clinical characteristics of foodborne botulism. The case histories of 23 patients diagnosed with foodborne botulism hospitalised at the Republican Clinical Infectious Diseases Hospital between 2022 and 2023 were retrospectively analysed. As a result of analysing case histories, it was found that the transmission factor was mainly home-canned fruits and vegetables. In more than 60% of cases, there was a delay in patients seeking medical help. In 26.1% of cases, clinicians initially made erroneous diagnoses. Adults (87%) and predominantly males (61%) predominated among the patients. Recently, however, botulism has been registered among children. The analysis showed that the patients had typical clinical symptoms of botulism with the development of symmetrical descending paralyses of cranial nerves and symptoms of myoplegia. The results of laboratory research showed that in Kyrgyzstan botulism is caused predominantly by botulinum toxins type A, B, E, at the same time empirical approach in the treatment of botulism with anti-botulinum serum using monovalent sera of these types is reasonable. Thus, early diagnosis and treatment of foodborne botulism reduces the risk of fatal outcome and improves the prognosis of the disease. Increasing public awareness is a preventive measure for the disease.

Artificial intelligence will not fully replace radiologists, but it will reshape their role—especially in image interpretation and patient care. Patients are often unsure how to respond to artificial intelligence related errors, while radiologists believe they must retain control and responsibility over diagnostic processes. Therefore, strategies for ethical accountability and stronger artificial intelligence education in medical training are essential. Collaboration between radiologists and IT specialists is crucial for patient-centered integration of these technologies. Objective. This study aimed to analyze physicians' perceptions of the use of artificial intelligence in radiology. A quantitative survey was conducted among 51 practicing physicians, including radiologists. The questionnaire explored issues such as patient data confidentiality, absence of human oversight, risk of skill loss, and interest in artificial intelligence applications. Results. The majority of respondents expressed positive attitudes towards artificial intelligence, highlighting its potential to enhance diagnostic speed and accuracy. However, concerns remain about loss of clinical skills, data privacy, and lack of human control. Over 60% of participants were interested in learning how artificial intelligence can be used in chest X-ray interpretation. Conclusion. Artificial intelligence is seen as a supportive tool, not a replacement for physicians. Successful implementation requires ethical guidelines, legal regulation, and the education of healthcare professionals to ensure safe and effective artificial intelligence integration. 

The sensation of a «lump in the throat», or «globus pharyngeus», is a common symptom that patients often describe as a feeling of a foreign body or pressure in the throat. It is most frequently associated with psychogenic factors, stress, or gastroesophageal reflux disease. However, in some cases, this sensation may be caused by organic pathologies that require careful diagnosis.
This article presents a clinical case in which persistent globus sensation was caused by hypertrophy of the lingual tonsil – a rare but clinically significant condition. The case emphasizes the importance of a comprehensive approach to patients with such complaints, including mandatory otolaryngological examination using modern imaging techniques.
This case highlights the need to rule out organic pathology when making a diagnosis and contributes to expanding the differential diagnosis for persistent globus sensation.

External nasal trauma is a common type of craniofacial injury, particularly in children and adolescents. Understanding its causes, anatomical structures involved, and clinical features is essential for timely diagnosis and effective treatment.
Objective: To analyze the etiology, morphological characteristics, clinical presentation, and treatment approaches for external nasal injuries.
Methods. The study involved clinical, otorhinolaryngological, ophthalmological, neurosurgical, radiological (including multi-slice computed tomography, magnetic resonance imaging, and conebeam computed tomography), and laboratory examinations. Patient medical records were analyzed to assess structural changes in the nasal bones, paranasal sinuses, orbits, and brain. Functional outcomes were evaluated using acoustic rhinometry; aesthetic results were assessed through photographic comparisons; and quality of life was measured using the Pediatric Quality of Life Inventory (PedsQL 4.0).
Results. The leading causes of nasal trauma were domestic accidents, sports injuries, and road traffic incidents. Fractures with nasal deformity were the most common type of injury, often requiring reposition. The optimal period for surgical intervention was found to be 5–10 days post-injury. A multidisciplinary approach significantly improved both functional and aesthetic outcomes.
Conclusion. Early diagnosis and timely management of external nasal trauma are critical for preventing complications and ensuring optimal functional and cosmetic results. A comprehensive, interdisciplinary evaluation is essential in managing such injuries effectively. 

This article presents the results of a retrospective analysis of the study of clinical and laboratory data of children with orbital complications of rhinosinusitis. The analysis showed that the greatest number of orbital complications occur in the younger group of children (1-7 years) - 72 (48%) patients, with acute sinusitis with complications, complaints were of increased body temperature, eyelid edema, headaches, and with chronic - chemosis and decreased vision prevailed. The most frequently detected growth of Staphylococcus aureus (45%). The analysis showed that timely initiation of treatment resulted in complete restoration of vision in almost all patients. In 1 patient with acute pansinusitis complicated by orbital phlegmon, vision in the right eye was not restored (the patient came on the 5th day after the onset of the disease). The effectiveness of the therapy conducted in rhinosinusogenic orbital complications depends on the correct etiotropic treatment. Determination of the species composition of microflora and its sensitivity to antibiotics is key. According to some authors, complex conservative treatment with the use of a lymphotropically sensitive antibiotic reduces surgical treatment of patients with rhinosinusogenic orbital complications. 

Neurofibromatosis type 1 is one of the most common genetic diseases. It can be inherited in an autosomal dominant manner, but in almost half of the cases it occurs de novo. Neurofibromatosis type 1 is associated with café au lait spots, freckles in the inguinal and axillary areas, neurofibromas, Lisch nodules of the iris or choroidal anomalies, optic pathway gliomas and characteristic bone anomalies. In the world, the pathology occurs with a frequency of 1:3500 newborns. Mutation in the NF1 gene, which is located on chromosome 17 q11.2, leads to the inability to synthesize the cytoplasmic protein neurofibromin. This latter protein acts as a modulator of cell growth and differentiation, starting from intrauterine life, it is expressed by cells of the nervous system, endothelium and smooth muscles near blood vessels. The mutated protein and associated changes in the cellular environment lead to a very high risk of cerebrovascular changes. Deficiency of the NF1 gene leads to hyperactivation of RAS, which triggers the AKT/mTOR and Raf/MEK/ERK proliferation signaling pathways. As a result, benign neoplasms are formed - neurofibromas, which have a high tendency to malignancy. The gold standard for diagnosing neurofibromatosis type 1 is molecular genetic testing. The article provides information on the prevalence, clinical picture, diagnostic and treatment options for neurofibromatosis type 1, as well as our own clinical observation. The presented clinical case is interesting due to the progressive course of the disease in a child and  the formation of multiple plexiform neurofibromas. Currently, there are no methods for preventing this pathology, but early diagnosis and targeted therapy improve the quality of life of patients. Targeted therapy can have a great impact and slow the growth of neurofibromas. Selumetinib is a selective inhibitor of mitogen-activated protein kinase types 1 and 2 (MEK 1,2). It blocks MEK activity and the Raf/MEK/ERK signaling pathway, which helps suppress the proliferation of tumor cells in which this signaling pathway is activated.

Gigantomastia is a rare but clinically significant form of breast gland hypertrophy, characterized by excessive enlargement of breast volume, often accompanied by physical and psychoemotional complications. Patients diagnosed with this condition frequently report back and neck pain, postural disturbances, restricted physical activity, and psychological distress related to body image and social integration. In recent years, the frequency of gigantomastia diagnoses has been steadily increasing. This is attributed not only to improved diagnostic capabilities and wider access to specialized care but also to growing awareness among both physicians and patients. Several countries in Europe and Asia have accumulated considerable clinical experience in the management of giantomastia. In contrast, Kyrgyzstan faces a lack of reliable statistical data and insufficient focused research. This prospective study presents the clinical experience of treating 42 patients with gigantomastia in Bishkek between June 2022 and December 2023. A comprehensive approach was implemented, combining surgical intervention with elements of conservative therapy. The one-year follow-up demonstrated the safety and high effectiveness of the chosen treatment strategy for gigantomastia within the framework of Kyrgyzstan’s national healthcare system.

Despite the use of modern instrumental research at the present time, the diagnosis of acute appendicitis in the elderly and senile is a difficult task, and for a surgeon, a thorough collection of complaints, anamnesis of the disease and identification of the main clinical signs are key elements in the diagnosis of the disease. Despite the large number of research scales and systems in emergency surgery, the Alvarado scale is one of the most widely used definitions observing the main signs of acute appendicitis. The Alvarado score was developed by Alfredo Alvarado in 1986 as a diagnostic tool for acute appendicitis. The evaluation was based on a retrospective study of 305 patients admitted to Nazareth Hospital in Philadelphia, Pennsylvania, USA, with abdominal pain consistent with acute appendicitis. This article describes the features of the diagnosis of acute appendicitis in the elderly and senile, as well as the use of the Alvarado scale. Due to its simplicity, the Alvarado scale is easy to use and improves the diagnosis of diseases, more accurately determines the indicators available for hospitalization, and also prevents “unnecessary” operations. Objective of the study: Validation of the Alvarado scale in the diagnosis of acute appendicitis in elderly and senile individuals. Materials andmethods. The study included patients diagnosed with acute appendicitis over 60 years of age in the main group, as well as patients aged 18 to 60 years in the control group. Total number of patients 180. A retrospective study of the case histories of 180 patients who were diagnosed with acute appendicitis and who underwent surgical treatment was conducted. Results. When diagnosing acute appendicitis in elderly and senile individuals, if the Alvarado scale score is 8 points, this can be considered as an indication for surgery. Conclusion. According to the results of our study, the Alvarado scale is of great help in diagnosing acute appendicitis in elderly and senile individuals and determines the path of further treatment. 

Upper eyelid blepharoplasty is one of the most sought-after aestethic surgeries worldwide, especially among patients of Asian descent. However, the anatomical features of Asian eyelids, such as the absence of a distinct crease, the presence of subcutaneous fat tissue, and the specific structure of the orbital septum, require an individualized approach to selecting surgical techniques. The article presents a comparative analysis of the anatomical features of 50 patients of Asian and European descent, focusing on anatomical differences, clinical outcomes, and patient satisfaction.
The aim of the study is to examine and compare the effectiveness of various surgical techniques for blepharoplasty in patients of Asian and European descent, as well as to identify factors influencing patient satisfaction with the results of the surgery. All surgeries were performed at the "MaxClinic" for Plastic and Reconstructive Surgery. The study used standardized questionnaires, analysis of medical records, and pre- and post-operative photographs. Data were processed using SPSS software.
The relevance of this study for Kyrgyzstan is due to the growing demand for aesthetic surgeries, including blepharoplasty, among the population with predominantly Asian ethnic features. In a multi-ethnic country where both Asian and European anatomical features are present, it is important to develop adapted surgical approaches that take into account the specifics of the local population. Conducting such research will improve the quality of medical services, reduce the frequency of complications, and enhance patient satisfaction, which is particularly important in the absence ofstatistical data in Kyrgyzstan.
The results of the study can be used to develop recommendations for performing blepharoplasty in Kyrgyzstan, as well as to train surgeons in modern techniques that consider the ethnic characteristics of patients. 

This review analyzes the individual anatomical and radiological characteristics of the structure, blood supply, and innervation of the mandible. The mandible is a key craniofacial structure involved in chewing, speech, and facial aesthetics. Morphological features, including variations in bony canals, neurovascular bundles, and cortical bone relief, are of great clinical significance in dentistry and maxillofacial surgery. The article systematizes data from 35 scientific sources selected based on relevance, methodological quality, and originality.
Particular attention is given to modern imaging techniques – cone-beam CT, MRI, and radiography, which enable identification of individual anatomical variations: the presence of lingual canals, radiodensity of the incisive canal, and the course of the mandibular canal and its proximity to dental roots. The clinical relevance of these structures is discussed in the context of anesthesia, dental implantation, surgery, and treatment planning.
The review emphasizes the need for a personalized approach and in-depth understanding of mandibular anatomical variations to improve safety and efficacy in dental and surgical procedures.