International Journal of Nursing and Medical Science (IJNMS) ISSN 2454-6674
International Journal of Nursing and Medical Sciences (IJNMS) International Journal of Nursing and Medical Sciences is an international scholarly referred research journal of Nursing & Medical Education and Research published quarterly. Areas of publication are: Adult medical-surgical nursing, Ethics and legal issues in nursing, Geriatric nursing, Maternal-child nursing, Medication administration, Midwifery, Nursing theory, Pediatric nursing, Psychiatric nursing, Anatomy, Biochemistry, Biomechanics, Biostatistics, Biophysics, Cardiology, Community medicine, Cytology, Dentistry etc.
BACTERIOPHAGE THERAPY: PROSPECTS AND CLINICAL SIGNIFICANCE
This article discusses the importance of bacteriophage therapy in modern medicine, its effectiveness against antibiotic-resistant bacteria, and its future prospects. Bacteriophages are viruses that infect bacteria and are characterized by high specificity. The article analyzes the advantages of phage therapy, its fields of application, laboratory studies, and practical results. In addition, current challenges and future perspectives of bacteriophage use are presented.
Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
IMPROVING COMMUNICATIVE COMPETENCE THROUGH TASK-BASED LANGUAGE TEACHING IN DENTISTRY ESP COURSES IN UZBEKISTAN
This study investigates the effectiveness of Task-Based Language Teaching (TBLT) in improving communicative competence among dentistry students studying English for Specific Purposes (ESP) at Tashkent State Medical University in Uzbekistan. Traditional language instruction in medical ESP classrooms often emphasizes grammar and vocabulary memorization rather than practical communication skills required in professional medical settings. Therefore, this research explores whether task-based activities such as patient–doctor dialogues, role plays, clinical simulations, and case discussions can enhance students’ speaking abilities and professional communication. The study employed a quasi-experimental research design involving 30 dentistry students with mixed English proficiency levels ranging from A2 to B2 CEFR levels. Data were collected through pre-tests, post-tests, classroom observations, and student questionnaires over a six-week instructional period. The findings demonstrated significant improvement in students’ fluency, confidence, vocabulary usage, and interactional competence. Furthermore, students expressed positive attitudes toward TBLT activities, reporting increased motivation and engagement during ESP lessons. The study concludes that TBLT is an effective pedagogical approach for teaching Medical English in dentistry ESP courses. The findings suggest that integrating authentic communicative tasks into ESP instruction can better prepare students for real-life professional communication in healthcare settings.
AYURVEDIC SURGERY FROM SUSHRUTA TO THE MODERN ERA: TRADITIONAL FOUNDATIONS AND EMERGING PERSPECTIVES IN INTEGRATIVE SURGICAL CARE
Ayurvedic surgery, designated Shalya Tantra constitutes one of the eight classical limbs of Ayurveda and represents one of antiquity's most systematised surgical traditions. The Sushruta Samhita, compiled by Acharya Sushruta circa 600 BCE, documents over 300 operative procedures, 121 surgical instruments, and pioneering techniques in rhinoplasty, wound management, cataract couching, and fracture care. This review traces the historical evolution of Ayurvedic surgical practice from Vedic roots through medieval consolidation, colonial-era suppression, post-independence revival, and the contemporary phase of evidence based integration with modern allopathic surgery. A landmark regulatory milestone the 2020 Central Council of Indian Medicine (CCIM, now NCISM) gazette notification formally authorises MS (Ayurveda) graduates in Shalya Tantra and Shalakya Tantra to perform 39 general surgical and 19 ENT/ophthalmology/oro-dental procedures independently after structured training. The review synthesises classical foundations, surgical instrumentation, parasurgical techniques, wound classification systems, regulatory frameworks, clinical evidence, ethical dimensions, and future directions, advocating rigorous evidence-driven integration to deliver patient-centred, cost-effective, and culturally sensitive surgical care.
ECOTOURISM POTENTIAL AND DEVELOPMENT IN THE REPUBLIC OF UZBEKISTAN
This article discusses the development and potential of ecotourism in the Republic of Uzbekistan, as well as the ongoing reforms, measures, and governmental decisions aimed at developing this sector and direction.
DRINKING WATER QUALITY AND ITS IMPACT ON PUBLIC HEALTH IN THE KHOREZM REGION, UZBEKISTAN: A NARRATIVE REVIEW OF EVIDENCE FROM 2008 TO 2025
Safe drinking water is a fundamental human right, yet millions of people in Central Asia remain exposed to poor-quality water sources. The Khorezm region of Uzbekistan faces compounding environmental challenges, including the consequences of the Aral Sea ecological disaster, agricultural runoff containing persistent organic pollutants, climate-driven salinization, and deteriorating water infrastructure. This narrative review synthesizes evidence from peer-reviewed literature published between 2008 and 2025 to characterize the current state of drinking water quality in Khorezm and its associations with public health outcomes, particularly in children. The review identifies three principal water quality concerns: (1) fluoride deficiency (0.14–0.38 mg/L; WHO recommended range: 0.7–1.5 mg/L), associated with elevated dental caries prevalence; (2) excessive total dissolved solids (TDS) and water hardness, linked to urolithiasis and cardiovascular disease; and (3) microbial contamination in groundwater wells, directly associated with diarrhoeal disease burden in children under five (4.6 episodes/child/year). Organochlorine pesticide residues (DDT, γ-HCH) and heavy metals detected above international thresholds further compound health risks. We conclude with evidence-based recommendations for water fluoridation programmes, sanitary protection of groundwater sources, and seasonal microbiological surveillance.
MODERN SURGICAL METHODS FOR THE TREATMENT OF METABOLIC SYNDROME: A COMPARATIVE ANALYSIS OF SADI-S, SASI-S, MINI GASTRIC BYPASS, AND ROUX-EN-Y GASTRIC BYPASS
Metabolic syndrome is one of the leading medical and social problems of modern medicine. Over the past decades, metabolic surgery has been considered the most effective method for achieving long-term remission in patients with obesity, type 2 diabetes mellitus (T2DM), and metabolic syndrome. The most commonly performed procedures include Roux-en-Y gastric bypass (RYGB), mini gastric bypass/one-anastomosis gastric bypass (MGB/OAGB), single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), and single anastomosis sleeve ileal bypass (SASI-S). The aim of this review is to provide a comparative analysis of the efficacy, metabolic outcomes, technical characteristics, and complications of these procedures in the treatment of T2DM. Analysis of current studies demonstrates that all methods produce significant antidiabetic effects; however, they differ in the degree of malabsorption, the risk of nutritional deficiencies, and the duration of diabetes remission. SADI-S demonstrates the most pronounced metabolic effect, whereas RYGB remains the “gold standard” with the most extensively studied long-term outcomes.
FORMING MEDIA CULTURE AND CRITICAL THINKING IN STUDENTS
This article analyzes the relevance, theoretical foundations, and practical methods of developing media culture and critical thinking skills in students. The role of media education in the information society and the need to develop immunity against fake news are highlighted based on scientific sources.
FORMULATION AND EVALUATION OF LORAZEPAM LOADED TRANSFEROSOMES FOR THE MANAGEMENT OF NEURODEGENERATIVE DISORDERS
Transferosomes are ultra-deformable vesicular carriers widely explored for enhanced transdermal drug delivery. These vesicles are composed mainly of phospholipids and edge activators, which impart high elasticity and deformability, enabling them to penetrate through the narrow pores of the stratum corneum. Transferosomes can encapsulate both hydrophilic and lipophilic drugs and deliver them effectively into deeper layers of the skin or systemic circulation. Due to their unique structure and flexibility, they provide improved drug permeation, prolonged release, enhanced bioavailability, and reduced systemic side effects compared to conventional dosage forms. Various preparation techniques such as rotary film evaporation, reverse phase evaporation, ethanol injection, vortex-sonication, and freeze-thaw methods are employed for their formulation. Characterization parameters including vesicle size, zeta potential, entrapment efficiency, morphology, drug content, and in vitro permeation studies are essential for evaluating their performance. Transferosomes have shown promising applications in the delivery of corticosteroids, NSAIDs, peptides, proteins, vaccines, herbal drugs, and anticancer agents. Despite limitations such as oxidative instability and difficulties in phospholipid purification, transferosomes remain a highly efficient and promising carrier system for controlled and targeted transdermal drug delivery. Their ability to overcome the barrier properties of the skin makes them an advanced and effective approach in modern pharmaceutical research.
SPECTROSCOPIC ANALYSIS OF BLOOD: NEW ADVANCES IN INFECTIOUS DISEASE DIAGNOSIS
This article reviews the role of spectroscopic analysis of blood, in particular Fourier transform infrared (FTIR) and Raman spectroscopy, in the detection of infectious diseases. The rapidity, high sensitivity, and cost-effectiveness of spectroscopy compared to traditional microbiological methods are highlighted based on statistical data.
Copyright (c) 2026 Zayniddinov Muhiddin, Muhammadiyeva Muhayyo https://creativecommons.org/licenses/by/4.0
DIAGNOSTIC SIGNIFICANCE OF CONE-BEAM COMPUTED TOMOGRAPHY IN ODONTOGENIC MAXILLARY SINUS
Odontogenic maxillary sinusitis is an important clinical problem associated with maxillary teeth and their periapical pathologies, and is widely encountered in modern otolaryngology and dentistry practice [1,2]. The anatomical location of the maxillary molar and premolar tooth roots close to the floor of the maxillary sinus creates conditions for easy spread of infection, resulting in the development of an inflammatory process in the sinus mucosa [3,4]. This study was aimed at assessing the diagnostic value of cone beam computed tomography (CBCT) in the detection of odontogenic maxillary sinusitis [5]. The study was conducted in a cross-sectional (cross-sectional) design with the participation of 60 patients aged 18–45 years who consulted dental and ENT clinics in Tashkent [6]. The images examined the thickening of the maxillary sinus mucosa (>3 mm), fluid level, osteomeatal complex status, and the distance between the tooth roots and the sinus floor [8]. The presence of caries and periapical lesions was determined by dental examination and their association with sinus pathology was assessed [9]. The results were processed using variational statistical methods, and the data were expressed as mean values and standard deviations (M ± SD). The level of statistical significance was considered p < 0.05 [10]. According to the results of the study, maxillary sinusitis of odontogenic origin was detected in 68.3% of patients, and the majority of them had periapical pathologies associated with the maxillary molar teeth [11]. The average thickness of the sinus mucosa was 5.6 ± 1.8 mm, which was significantly higher than in the healthy control group (p < 0.01) [12]. In addition, it was found that the risk of developing sinusitis increased as the distance between the tooth root and the sinus floor decreased, and a negative correlation was noted between them (r = –0.62, p < 0.05) [13]. Cone beam computed tomography (CBCT) demonstrated clear visualization of pathological changes in 91.6% of odontogenic sinusitis cases, demonstrating higher diagnostic accuracy than plain radiography (p < 0.01) [14]. A statistically significant correlation was also observed between clinical symptoms and radiological changes (r = 0.58, p < 0.05) [15]. In conclusion, cone beam computed tomography has a high diagnostic value in the early and accurate detection of odontogenic maxillary sinusitis and is important in the differential diagnosis of dental and otolaryngological pathologies [16].
CLINICAL SIGNIFICANCE AND ANCIENT PERSPECTIVES OF PLASTIC RECONSTRUCTIVE AND COSMETIC SURGERY W.S.R TO SANDHAN KARMA
Plastic surgery is a specialized branch of surgery which focuses on restoring the shape and function of lost or damaged tissues and skin. As a result, the dermal repair performed by a plastic surgeon can include both reconstructive and cosmetic procedures. The field of plastic surgery offers a unique opportunity to incorporate surgical techniques into the treatment of patients based on their unique needs through the manipulation of bone, cartilage and soft tissue through the processes of re-modeling, reshaping and re-arranging. These methods in Ayurveda come under the heading of Sandhan Karma which is a surgical method that was first documented by Acharya Sushruta and this technique has similarities to plastic surgery. Sushruta’s contributions included his description of the Shashti Upakrama. Sandhana or Sandhan Karma means putting together separated/damaged parts of the body. Since Sushruta’s philosophies regarding reconstructive surgery have existed for thousands of years, they have evolved to keep pace with contemporary plastic and reconstructive surgical procedures for lip, ear, and nose reconstruction (Oshtha Sandhan, Karna Sandhan and Nasa Sandhan). The objective of this article is to discuss the terminology, theories, and methods associated with Sandhan Upakrama as presented in Ayurvedic literature as compared to current day plastic and reconstructive surgical methods.
CONTACT LENS SAFETY AMONG YOUTH: COMMON MISTAKES AND PREVENTION
This article provides information about contact lens safety among young people, common mistakes, and preventive measures. The widespread use of contact lenses among modern youth and the reasons for their usage are discussed. The study analyzes eye infections, dryness, and other health problems that arise from improper use of lenses. In addition, types of contact lenses and their importance are also described. Furthermore, preventive measures such as following hygiene rules, monitoring usage duration, avoiding contact with water, and regular eye examinations are explained in detail. The article is aimed at increasing awareness of safe contact lens use and maintaining eye health among young people. Keywords: Contact lenses, optical device, optical correction, Leonardo da Vinci, colored and decorative lenses, myopia, hyperopia, astigmatism, presbyopia, hypoxia.
MODERN METHODS OF TREATING HYDROCEPHALUS IN CHILDREN. COMPARATIVE ANALYSIS OF SHUNTING AND ENDOSCOPIC METHODS
Modern surgical methods, in particular shunting and neuroendoscopic procedures, are widely used in the treatment of pediatric hydrocephalus. This article presents a comparative analysis of shunting methods (ventriculoperitoneal shunts) and endoscopic treatment methods (Endoscopic Third Ventriculostomy (ETV) and ETV with choroid plexus catheterization (ETV+CPC)). The article evaluates the effectiveness, safety, complications, and results of the methods in different age groups. Based on an analysis of the available scientific literature, the advantages and disadvantages of both methods are highlighted, and the importance of considering factors such as the patient's age, the etiology of hydrocephalus, and the results of previous procedures when choosing a treatment method is emphasized. The article also discusses technological advances and future prospects in pediatric neurosurgery. Keywords:Hydrocephalus, shunting, Endoscopic third ventriculostomy, ETV+CPC, pediatric neurosurgery, treatment methods
DIAGNOSTIC AN ACCURACY OF ULTRASOUND EXAMINATION OF FETUSES AND NEWBORNS IN DETECTING CONGENITAL ABNORMALITIES OF THE DIGESTIVE ORGANS
Congenital anomalies of the digestive organs occupy a significant place in the structure of perinatal pathology and require timely diagnosis. The aim of this study was to evaluate the diagnostic accuracy of ultrasound examination in fetuses and newborns when identifying congenital anomalies of the digestive organs. A prospective cohort study was conducted involving 298 pregnant women and their newborns. Prenatal ultrasound examination was performed at gestational ages of 18–22 and 30–34 weeks, while neonatal ultrasound was performed during the first 5 days of life. The sensitivity, specificity, and prognostic value of the method were evaluated. Congenital anomalies were identified in 26 (8.7%) cases. Prenatal ultrasound sensitivity was 80.8%, and specificity was 95.9%. The comprehensive use of prenatal and neonatal ultrasound increased diagnostic accuracy to 93.5%. The results obtained indicate the high effectiveness of ultrasound examination, especially when used in combination. Key words: ultrasound, prenatal diagnosis, newborns, congenital anomalies, digestive organs.
DIAGNOSTIC ACCURACY OF ULTRASOUND EXAMINATION FOR IDENTIFYING CONGENITAL ANOMALIES OF THE DIGESTIVE SYSTEM IN FETUSES AND NEWBORNS
This study aimed to evaluate the diagnostic accuracy of ultrasound examination for identifying congenital anomalies of the digestive system among fetuses and newborns. The study was conducted as a prospective cohort study involving 298 pregnant women and their newborns. Prenatal ultrasound examinations were conducted at 18–22 and 30–34 weeks of gestation, while neonatal examinations were performed within the first 5 days of life. During the study, the sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound examination were statistically evaluated. The results indicated that congenital anomalies of the digestive system were detected in 26 (8.7%) cases, with the ultrasound examination demonstrating a sensitivity of 80.8% and specificity of 95.9%. The combined application of prenatal and neonatal ultrasound examinations enabled an increase in overall diagnostic accuracy up to 93.5%. The results demonstrate that ultrasound examination is an effective diagnostic tool for early detection of congenital anomalies and confirm that its greatest diagnostic accuracy is achieved when utilized in combination during both prenatal and neonatal periods. Keywords: ultrasound examination, prenatal diagnosis, newborn, congenital anomaly, digestive system, diagnostic accuracy
PRENATAL AND NEONATAL ULTRASOUND SCREENING IN THE EARLY DIAGNOSIS OF CONGENITAL MALFORMATIONS OF THE DIGESTIVE SYSTEM: A PROSPECTIVE COHORT STUDY
Objective: To evaluate the diagnostic effectiveness of prenatal and neonatal ultrasound screening in the early detection of congenital malformations of the digestive organs. Materials and Methods: A prospective cohort study was conducted involving 312 pregnant women and their newborns. Prenatal screening was performed at 18-22 and 30-34 weeks of gestation, and neonatal screening during the first 7 days of life. The sensitivity, specificity, and predictive value of the method were evaluated. Results: Congenital anomalies of the digestive organs were detected in 28 (9.0%) fetuses/newborns. The sensitivity of prenatal ultrasound was 82.1%, and the specificity was 96.4%. Neonatal ultrasound increased the overall diagnostic accuracy to 94.2%. Conclusion: Combined prenatal and neonatal ultrasound screening is a highly effective method for the early diagnosis of congenital anomalies of the digestive system and facilitates timely clinical intervention. Keywords: ultrasound, prenatal diagnosis, newborns, congenital anomalies, digestive system, screening.
ECHOCARDIOGRAPHIC AND PROGNOSTIC ASSESSMENT OF LEFT VENTRICULAR REMODELING AND COMPLICATIONS IN PATIENTS AFTER MYOCARDIAL INFARCTION (A CASE STUDY OF THE KASHKADARYA REGION)
This study is devoted to the assessment of left ventricular remodeling processes, echocardiographic parameters, and prognostic significance of complications in patients after myocardial infarction, based on clinical observations in the Kashkadarya region. Myocardial infarction remains one of the leading causes of morbidity and mortality worldwide, and post-infarction remodeling of the myocardium plays a crucial role in determining long-term outcomes. The aim of the study was to evaluate structural and functional changes in the left ventricle using echocardiography and to analyze their relationship with the development of early and late complications. The research included patients with a confirmed diagnosis of myocardial infarction, who underwent comprehensive clinical and instrumental examination, including echocardiographic evaluation. Key parameters such as left ventricular ejection fraction, end-diastolic and end-systolic volumes, wall thickness, and regional contractility were analyzed. The results demonstrated that adverse remodeling patterns, characterized by ventricular dilatation and reduced systolic function, were associated with a higher incidence of complications, including heart failure, arrhythmias, and recurrent ischemic events. The findings highlight the importance of early echocardiographic assessment in identifying high-risk patients and optimizing individualized management strategies. Regional analysis in the Kashkadarya population also underscores the need for improved diagnostic and therapeutic approaches tailored to local healthcare conditions. Keywords: myocardial infarction, left ventricular remodeling, echocardiography, prognosis, complications, heart failure, regional analysis, Kashkadarya region.
STUDY OF THE DETECTION OF PCR PRODUCTS USING STANDARD AGAROSE GEL ELECTROPHORESIS
This thesis investigates the detection of DNA products obtained through Polymerase Chain Reaction (PCR) using standard agarose gel electrophoresis. The study analyzes the ability to determine the presence, size, and quality of PCR products. The results demonstrate that agarose gel electrophoresis is a simple, accurate, and reliable method. This technique is widely used and plays an important role in molecular biology and genetics. Enter Currently, molecular biology and genetics are one of the fastest growing fields. Scientific research in these areas serves to deeply study the genetic structure of living organisms, identify hereditary diseases, and improve biotechnological processes. In particular, the analysis of the DNA molecule and the identification of its components remains one of the main tasks of modern biology. In this regard, methods for amplifying and identifying DNA fragments are of great scientific and practical importance. Polymerase chain reaction (PCR) is one of the most important methods for amplifying DNA fragments in vitro. This method can be used to amplify very small amounts of DNA samples to millions of copies in a short time. PCR technology is widely used in medicine for early detection of diseases, in forensics for personal identification, and in agriculture for genetic selection. Therefore, the detection of PCR products and their quality assessment are important stages. There are various methods for analyzing the products obtained after the PCR process, among which the agarose gel electrophoresis method is considered the most common and effective. This method is based on the separation of DNA molecules according to their size under the influence of an electric field. With the help of agarose gel electrophoresis, it is possible to determine the length of DNA fragments, confirm their presence, and assess the success of the amplification process. The advantages of the agarose gel electrophoresis method are its simplicity, cost-effectiveness, and high accuracy. In addition, this method allows for rapid results in laboratory conditions. At the same time, this method can also detect incorrect amplification, contamination, or other technical errors. This increases the reliability of the results of scientific research.
MOLECULAR BIOLOGICAL DIAGNOSIS OF ORAL CAVITY AND OROPHARYNGEAL CANCER AND METHODS OF THEIR TREATMENT
The analysis of the study results demonstrated the significance of determining the serum concentration of vascular endothelial growth factor (VEGF) in patients with oropharyngeal cancer. In combination with immunological indicators, this marker helps diagnose severe forms of the disease process and is also important in predicting the risk of recurrence. A comprehensive approach to immunodiagnostics, virological diagnostics, treatment, and prognosis of disease progression was developed depending on immune status indicators, virological characteristics of Epstein–Barr virus, and the level of vascular endothelial growth factor.
ERYTHROCYTE DEFORMABILITY AND ITS ROLE IN MICROCIRCULATION
This article examines erythrocyte deformability—the ability of red blood cells to change their shape—and its fundamental importance in the process of microcirculation. The study analyzes molecular factors affecting erythrocyte flexibility, particularly the role of membrane proteins and intracellular viscosity. Using ektacytometry and microfiltration methods, blood samples from healthy individuals and patients with various pathologies (such as diabetes mellitus and arterial hypertension) were comparatively studied. The results indicate that reduced erythrocyte deformability increases blood viscosity, leading to tissue hypoxia and microvascular complications. The article concludes with findings on the clinical significance of improving erythrocyte rheological properties. Keywords: erythrocyte deformability, microcirculation, hemorheology, capillary flow, ektacytometry, viscosity, membrane elasticity, hypoxia
THE ROLE OF QUADRUPLE THERAPY IN PATIENTS WITH ISCHEMIC CARDIOMYOPATHY UNSUITABLE FOR REVASCULARIZATION: A CLINICAL CASE REPORT
Coronary artery disease (CAD) is one of the most prevalent cardiovascular disorders and remains the leading cause of disability and mortality worldwide. In developed countries, CAD is the major cause of heart failure, accounting for nearly 60% of chronic heart failure cases. This clinical case demonstrates the management of a patient with ischemic cardiomyopathy and severe heart failure following myocardial infarction. The treatment of patients with ischemic cardiomyopathy and the selection of optimal quadruple therapy remain a major clinical challenge for cardiologists. Considering the increasing number of patients with ischemic cardiomyopathy who are not candidates for coronary revascularization, this clinical case is of particular importance. Quadruple therapy (ACE inhibitors/ARBs/ARNI, beta-blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors) represents the cornerstone of treatment in patients with ischemic cardiomyopathy who are not suitable for revascularization. This therapeutic strategy improves quality of life, enhances prognosis, prolongs survival, and reduces hospitalization and mortality associated with heart failure. Keywords: ischemic cardiomyopathy, quadruple therapy, revascularization, heart failure.
Annotation. Spinal cord injury (SCI) is a severe pathological condition resulting from damage to the vertebral column and spinal cord, accompanied by impairment of motor, sensory, and autonomic functions. This paper examines the structure of SCI , including the anatomical features of the spine and spinal cord, injury mechanisms, and morphological and functional changes associated with various types of injury. Particular attention is paid to the classification of injuries, their clinical manifestations, and the importance of timely diagnosis. Based on the data analysis, approaches to assessing the severity of injury and preventing complications have been developed. SCI is a pressing issue in practical medicine. The incidence of SCI is steadily increasing. According to literature reports, the proportion of spinal fractures in the overall structure of skeletal trauma has ranged from 2 to 18% of cases in recent years, with an upward trend. Damage to the spinal cord and its roots accounts for approximately 20% of all spinal injuries. Disability due to spinal cord injury hovers around 80%, two-thirds of whom are people of working age. Mortality from complicated spinal cord injury also remains high, reaching 35% according to summary statistics. The literature reviewed above clearly illustrates not only the prevalence and severity of spinal cord injury but also the importance of treating victims at all stages of surgical care. It is known that the key conditions for adequate surgical treatment of complicated spinal injury in the acute period include decompression of the spinal cord and its roots, correction of post-traumatic deformity, stabilization of vertebral segments, and prevention of degenerative changes in the spine and spinal cord. While the need for decompression in cases of spinal cord and root compression is currently non-negotiable and should be performed without fail, the choice of method for stabilization and correction of post-traumatic deformity remains controversial. In the current stage of neurosurgery, increasing attention is being paid not only to eliminating vertebral -medullary conflict but also to maintaining stability in the operated segment, preserving its proper anatomical, spatial, and biomechanical relationships to prevent the development and progression of neurological disorders and degenerative changes in the intervertebral motion segments, as well as those adjacent to the injury level. The presence of an unstable injury creates a risk of secondary displacement or worsening vertebral displacement, which requires reliable immobilization of the spine or surgical stabilization of the damaged segment. The term " decompression -stabilization" surgery encompasses two key concepts, including both "decompression" and "stabilization," which define the goals of surgical treatment. "Decompression" refers to the release of the neurovascular structures of the spinal canal from one or more compressive factors (a displaced vertebral body, bone fragments, localized hemorrhages, foreign bodies, etc.). "Stabilization" refers to the elimination of mobility and immobilization of all damaged supporting structures in the spine being operated on. The tactics for performing this type of surgical intervention, particularly in emergency neurosurgical settings, require special attention when choosing the method of stabilizing the damaged spinal motion segment (SMS). Fusion plays a significant role in ensuring the stability of the operated spinal segment . Maintaining stability in the operated spine after restoration of proper relationships creates the conditions for the formation of a complete bone block. Therefore, many authors discuss the need for additional posterior fixation of the injured spine. In this regard, the use of Harrington-type metal structures, parallel vertebral plates such as those used at the Central Institute of Traumatology and Orthopedics (CITO), titanium nickelide devices with shape memory effect (SME) and superelasticity (SE), as well as various variants of combined fusion using grafts in the treatment of complicated spinal injuries in emergency neurosurgical care, are worthy of consideration. Undoubtedly, in such cases, the time course of the traumatic disease remains important and must be taken into account when choosing the stage, tactics, and extent of surgical intervention. These, in turn, depend on the timing of patient examination, the method of decompression, and the technique and reliability of metal implant placement. According to epidemiological studies and assessments of the organization of medical care for patients with spinal cord injury, many factors influencing the quality of treatment remain relevant. These include the training of neurosurgeons; late and poor diagnostics and their cost-effectiveness; the complexity and high cost of devices for metal osteosynthesis ; inappropriate surgical tactics; and the risk of potential complications. All of the above determines the feasibility of continuing research on improving the treatment of patients with spinal cord injury in the context of emergency neurosurgical care.
DIABETES MELLITUS: COMPREHENSIVE PATHOPHYSIOLOGY, DIAGNOSIS, MANAGEMENT, AND CLINICAL PERSPECTIVES
Diabetes mellitus (DM) is a chronic, multifactorial metabolic disorder characterized by persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both. It has emerged as a major global health concern, affecting over 500 million individuals worldwide. The increasing prevalence of diabetes is closely associated with lifestyle changes, urbanization, obesity, and genetic predisposition. This article provides a comprehensive and expanded analysis of diabetes mellitus, including its classification, pathophysiology, clinical manifestations, diagnostic criteria, and modern management strategies. Special attention is given to the differences between type 1 and type 2 diabetes, as well as gestational diabetes.
CLINICAL AND MORPHOLOGICAL SKIN LESIONS IN THE STRUCTURE OF CONNECTIVE TISSUE DYSPLASIA
Relevance of the problem. Connective tissue dysplasia (CTD) is one of the most important medical and social problems of congenital pathology due to its progressive course, multiorgan involvement, and often unfavorable outcome. Data on the prevalence of CTD are contradictory: the detection rate of individual manifestations in the population varies from 8.5% to 85.4%, which is due to different classification and diagnostic approaches. Currently, differentiated and undifferentiated connective tissue dysplasia (UCTD) are distinguished. UCTD is diagnosed when a patient's set of phenotypic features does not fit the clinical picture of any known differentiated hereditary disease . The literature contains numerous publications on cardiovascular and musculoskeletal system damage in UCTD. According to the authors, skin pathology in UCTD reaches 18.0%. However, the description and frequency of manifestations of individual signs of skin pathology in different studies are contradictory, and their diagnostic significance has not been determined. Few studies by dermatologists have been devoted to assessing the impact of the dysplastic process on the course of associated skin pathology. A direct correlation has been established between the severity of clinical manifestations of atopic dermatitis and the severity of CTD. Researchers point to the pathogenetic significance of a deficiency of copper, zinc, and magnesium ions in the development of the main clinical symptoms of CTD [82]. It has been established that a deficiency of these micro- and macroelements leads to increased degradation of collagen and elastin fibers, as well as hyaluronan polysaccharide threads , which ultimately leads to a decrease in the mechanical strength of connective tissue. However, the diagnostic significance of determining the level of micro- and macroelements in patients with CTD, its relationship between external and internal signs, and minor developmental anomalies (MDAs) has not been sufficiently studied. Thus, the study of the signs and MARs of the skin in UCTD, the assessment of the frequency of occurrence and the determination of their diagnostic significance taking into account the principles of medical statistics, the development of a diagnostic algorithm taking into account modern regulatory documents, with the aim of providing highly qualified specialized dermatovenereological medical care that ensures the appropriate quality of preventive measures aimed at the early detection of UCTD using clinical and laboratory data, is relevant and is of scientific and practical interest.
DETERMINATION OF TOTAL CORTISOL LEVEL IN BLOOD SERUM
Relevance of the problem. In recent years, the problem of connective tissue dysplasia, the most common and frequently diagnosed manifestation of which is mitral valve prolapse, has attracted the close attention of researchers. MVP is diagnosed, according to various sources, in 1.8% to 38% of the population. Of particular importance is the fact that most individuals with newly diagnosed MVP are young, and assessing their ability to work, childbearing potential, and military service is of great practical importance. The prognosis for MVP, the need for, and methods of treatment remain poorly understood. The etiology and pathogenesis of MVP require clarification. The literature suggests the presence of a genetically determined defect in collagen synthesis, a decrease in interstitial magnesium ( Mg ), a deficiency of which leads fibroblasts to produce defective collagen in the mitral valve leaflets. Skin is one of the most accessible structures for studying the characteristics of dysplasia. There are isolated reports in the literature on skin structure studies in patients with mitral valve prolapse. The need to study this issue appears important and may, to some extent, clarify some aspects of mitral valve prolapse pathogenesis and serve as a method for monitoring treatment effectiveness. It is believed that various clinical symptoms in patients with MVP are also dependent on Mg deficiency . Studying certain aspects of Mg metabolism and its impact on the dynamics of MVP is highly relevant. The increased incidence of infectious diseases may also be related to this, as Mg deficiency leads to immune system dysregulation . The state of the interferon system in individuals with MVP has not been studied. The role of psychovegetative and hormonal disturbances in the structure of MVP is still debated. Determining the level of cortisol, a stress hormone and one of the main immune-regulatory hormones, may reveal clinical, immune, and hormonal correlations that explain disturbances in the immune system and neuropsychiatric status. We found no studies of K levels in these individuals in the available literature. Most publications indicate a significant prevalence of anxiety disorders in patients with MVP, reaching 31.0-44.6%. A hypothesis has been advanced regarding the possibility of "functional" MVP developing within panic disorder. Several authors argue that panic attacks can not only be "initiated" by MVP but can also lead to the development of its symptoms. The lack of consensus on this issue underscores the relevance of studying psychopathological changes in individuals with MVP.
REFORMS IN THE SOCIAL SPHERE IN UZBEKISTAN: THE CASE OF HEALTHCARE
This scientific article analyzes the priority directions for modernizing the social sphere in the Republic of Uzbekistan, particularly the fundamental reform of the healthcare system. The study comparatively examines fundamental literature, scientific sources, and regulatory legal documents related to the field. Reforms in healthcare are substantiated not only within the framework of state programs but also on the basis of social management and modern medical sociology theories. The article highlights the strengthening of primary healthcare, the introduction of digital medicine (E-health), and the scientific and practical significance of medical insurance mechanisms. The author integrates advanced international healthcare practices with classical socio-economic theories and outlines the specific features of the national model. In the conclusion, scientific findings and practical recommendations are proposed to further improve the efficiency of the healthcare system and elevate public health protection to a new level.
WOUND DRESSING ROOM AND ALGORITHM FOR PERFORMING BANDAGING OPERATIONS IN IT
Annotation. This scientific article extensively analyzes the concept of a wound dressing room and the algorithm for performing dressing procedures in it. The research also explains 5 steps that are considered important for performing dressing procedures.
CLASSIFICATION OF COMPLEX ANATOMICAL VARIANTS IN PEDIATRIC PATIENTS AFTER URANOPLASTY: AN INTEGRATED DIGITAL AND BIOCHEMICAL MONITORING APPROACH
Background: Cleft palate (CP) remains one of the most prevalent congenital craniofacial anomalies globally, affecting approximately 1 in 700 live births. Although uranoplasty restores anatomical continuity of the palate, post-surgical rehabilitation is frequently complicated by residual neuromuscular imbalances, altered occlusal dynamics, and compromised mucosal immune function. The absence of an integrated, multimodal monitoring framework limits the clinician's ability to detect and address these sequelae in a timely manner. Objective: This study aimed to develop and validate an integrated classification of complex anatomical variants observed in post-uranoplasty pediatric patients, and to evaluate the effectiveness of digital monitoring combined with biopolymer aligner-based orthodontic therapy on neuromuscular, occlusal, and biochemical outcomes. Methods: A prospective clinical observational study enrolled 150 children aged 6–12 years, divided into three groups of 50: a main group receiving digital monitoring with electromyography (EMG), T-Scan occlusal analysis, and biopolymer aligner therapy; a comparison group receiving conventional orthodontic treatment; and a healthy control group. Salivary biomarkers—alpha-amylase and secretory immunoglobulin A (sIgA)—were quantified at baseline and after 12 months. Statistical analysis employed the Mann–Whitney U test, Wilcoxon signed-rank test, and Spearman correlation (significance: p<0.05). Results: At baseline, masseter peak amplitude in the main group was 118.4 ± 12.3 μV, representing a 2.1-fold reduction versus controls (247.3 ± 18.6 μV; p<0.001). Muscular asymmetry index reached 31.4 ± 3.4%. Total occlusion time was prolonged approximately fourfold (1.82 ± 0.21 s vs. 0.46 ± 0.06 s in controls; p<0.001). Salivary alpha-amylase was elevated 2.2-fold relative to healthy peers. After 12 months, the main group demonstrated statistically superior improvements in all parameters compared to the comparison group (p<0.05 for all outcomes). Conclusion: Integrated digital monitoring combining EMG, T-Scan, and salivary biomarkers enables a precise, evidence-based classification of post-uranoplasty anatomical variants and substantially enhances rehabilitation outcomes. Early multimodal intervention is recommended for all pediatric patients following cleft palate repair.
Copyright (c) 2026 Anvarova Muhtasar Anvarovna https://creativecommons.org/licenses/by/4.0
IMPACT OF THE DMED PLATFORM ON THE EFFICIENCY OF MEDICAL INSTITUTIONS
This article examines the impact of the DMED (Digital Medical Electronic Documentation) platform, which is being actively implemented in the healthcare system of Uzbekistan, on the efficiency of medical institutions. Particular emphasis is placed on the fact that electronic medical records have significantly reduced the volume of paper documents and made it possible to allocate resources more efficiently. The article discusses the fact that the widespread implementation of the DMED platform in medical institutions has led to a fundamental improvement in the quality and efficiency of healthcare services.