Kyrgyz State Medical Academy

The article examines the historical aspects of the formation and development of the dermatovenerological service in the Soviet Union, as well as the specifics of its subsequent formation in the Russian Federation, the Kyrgyz Republic, the Republic of Tajikistan and the Republic of Uzbekistan. The results obtained make it possible to identify the characteristic features of the formation and priority areas of development of the dermatovenerological service in each country, defining tasks to improve the accessibility and effectiveness of specialized medical care.

Occlusive hydrocephalus in children remains a pressing problem in pediatric neurosurgery. Traditional treatment using cerebrospinal fluid shunting (CSF shunting) is associated with a high risk of complications and lifelong shunt dependence. In recent years, endoscopic third ventriculocisternostomy (ETV) has been considered a pathogenetically justified alternative to shunting interventions; however, data on its use in the Kyrgyz Republic were previously lacking. This study presents an analysis of the treatment outcomes of 26 children with occlusive hydrocephalus, aged 1 month to 17 years, treated from February 2020 to September 2022. Endoscopic ventriculocisternostomy was performed in 25 patients. Preoperative examination included magnetic resonance imaging of the brain using phase-contrast CSF flow sequences. The clinical follow-up period ranged from 4 to 31 months. The primary clinical effect after EVCS was achieved in 76% of patients, in 8% of cases a repeat procedure was required due to stoma closure. The overall effectiveness of the method was 84%. In 16% of cases, there was no positive effect, which required ventriculoperitoneal shunting. The lowest effectiveness of EVCS was noted in posthemorrhagic occlusive hydrocephalus. Postoperative intracranial hemorrhages, infectious complications and fatal outcomes were not registered. The obtained results indicate high clinical efficacy and safety of endoscopic ventriculocisternostomy of the third ventricle with proper patient selection and confirm the feasibility of its widespread implementation in the practice of treating occlusive hydrocephalus in children.

Kyrgyzstan, yrysbaev1996@gmail.com Abstract. The article examines the features of laboratory parameters in pregnant women with preeclampsia depending on age (under 35 years and 35 years and older) in the conditions of the Osh region, specifically in the maternity ward of the Osh Interregional Clinical Hospital (OICH). Preeclampsia is a serious complication of pregnancy characterized by dysfunction of the cardiovascular, renal, and other systems, with subsequent development of multiple organ failure. The study includes a comparative analysis of the main biochemical, hematological, and clinical parameters in two age groups. Particular attention is paid to the complete blood count, changes in urine protein levels, blood coagulation parameters, and other markers indicating the severity of preeclampsia. The obtained data highlight age-related differences in the course of this condition, which may be important for diagnosis, prognosis, and selection of treatment strategies for pregnant women with preeclampsia. The study results suggest that age-specific characteristics of patients should be taken into account when developing therapeutic and preventive measures.

Demyelinating diseases of the central nervous system (CNS) in children represent a serious neurological problem, often leading to severe neurological deficits and disability. Discrete manual plasmapheresis (DMP) is used to remove circulating autoantibodies, immune complexes, and proinflammatory mediators. We present a clinical case of a 10-year-old child with an acute exacerbation of demyelinating disease after influenza. DMP was used in combination with pulse methylprednisolone therapy. Neurological status was assessed using the EDSS scale upon admission, during treatment, and at discharge. Laboratory monitoring included a complete blood count, biochemistry, coagulation profile, and electrolytes. After 4 DMP sessions, a reduction in the severity of neurological deficit was noted: the EDSS decreased from 8.5 to 7.0. Active movement in the left limbs was restored, phonation and swallowing improved, and muscle tone decreased. Laboratory tests showed normalization of inflammatory parameters. Discrete manual plasmapheresis is an effective treatment method for acute demyelinating diseases of the central nervous system in children, achieving significant clinical improvement when combined with hormonal therapy. The results are consistent with international literature confirming the evidence-based efficacy of plasmapheresis in autoimmune processes of the central nervous system.

The purpose of the study : to study the features of the frequency and nature of high amputations performed in the Kyrgyz Republic. Materials and methods . The statistical indicators of the database "Treated case" of the Compulsory Medical Insurance Fund of the Kyrgyz Republic from January to December 2022 were studied, which included gender, age, ways of hospitalization, main and concomitant diagnoses, duration of hospitalization, duration of stay in the intensive care unit, main and repeated surgical interventions, frequency and structure of complications, outcome. Research results . In the Kyrgyz Republic, from January 1 to December 31, 2022, amputations of the lower extremities were performed in 923 patients. Of these, 41.5 % are women, 58.5 % are men. By age, there was a predominance of elderly (36.7 ± 1.6%) and middle-aged (35.5 ± 1.6%), less senile (14.1 ± 1.1%) and young (13.7 ± 1.1%). The main causes of amputations were complicated forms of diabetic foot syndrome (65.7 %), less often vascular diseases without diabetes mellitus (18.3 %) and other causes: injuries, purulent bone diseases and others (16.0 %). The average duration of hospitalization was 13.4 ± 1.8 days. High amputations were performed in 34.1 %, and small amputations in 65.9 % of cases. The ratio of transtibial to transfemoral amputations was 1 : 9.1. Reamputations in the early postoperative period after high amputations were performed in 8.6% of cases due to the development of purulent necrotic complications. The mortality rate for all amputations in the early postoperative period was 2.3 %, and in the group of patients after high amputations, the mortality rate was 7.7 times higher (5.4 %) than after small amputations. Conclusions. The high proportion of high amputations in patients of working age, mainly due to purulent-necrotic complications of diabetic foot syndrome, confirms the high social significance of the medical problem. The predominance of transfemoral amputations over transtibial amputations in the structure of high amputations, the high proportion of reamputations in the early postoperative period indicates the need to develop and implement a strategy for surgical treatment of purulent necrotic lesions of the lower extremities in patients with diabetes mellitus and in its absence.

The traditional surgical education model ("see one, do one, teach one") no longer meets contemporary patient safety standards. Simulation training, based on the principles of deliberate practice, is a fundamental component of modern medical education. To conduct a comprehensive analysis of the current state of surgical simulation training, summarize data on the efficacy of various training formats, including the development of Non-Technical Skills (NTS) and economic profitability, and identify promising future directions for simulation technologies in CIS countries. A systematic narrative review of domestic and foreign literature (2003–2025) was performed. Various training formats (dry-lab, wet-lab, VR technologies) were analyzed, and indicators of proven efficacy were examined, including the skill transfer coefficient, Return on Investment (ROI), and the impact on non-technical skills. The combined approach (dry-lab → VR → wet-lab) provides optimal training, achieving a skill transfer coefficient in clinical practice of up to 88.9%. A 91.7% increase in surgeon confidence and a 58.3% reduction in operative time were noted. Simulation has proven effective in developing NTS and demonstrates a positive ROI due to reduced complications. Simulation infrastructure is actively being developed in CIS countries. Conclusions: Simulation training has proven its effectiveness and is an integral part of surgical preparation. Key challenges (high cost, simulation gap) were identified, and practical recommendations were proposed. Future development is linked to the integration of Artificial Intelligence (AI), the advancement of telesimulation, and the standardization of competency assessment.

Acute appendicitis in elderly and senile patients is a serious clinical problem associated with a high frequency of diagnostic errors and late seeking of medical care. In this age category, the classic symptoms of the disease are often erased due to age-related changes in the nervous system, decreased pain sensitivity and reactivity of the peritoneum, as well as atrophic processes in the muscular-ligamentous apparatus. This leads to a predominance of nonspecific symptoms—weakness, low-grade fever, and bowel disturbances—which complicates timely diagnosis. A delay in diagnosis contributes to the development of destructive forms of appendicitis and increases the risk of postoperative complications. This article presents a comparative analysis of clinical manifestations in patients of different age groups, the results of which contribute to improving the diagnosis and treatment of acute appendicitis in elderly and senile patients.

Abstract Background Hypoplastic Left Heart Syndrome (HLHS) is a severe congenital heart disease characterized by underdevelopment of the left heart structures, often requiring staged surgical palliation. Despite improvements in surgical management, HLHS is associated with high mortality and long-term morbidity. Stem cell-based therapies have emerged as a promising adjunct to improve cardiac function and outcomes in these patients. Objectives This systematic review evaluates the long-term safety and efficacy of stem cell therapy, particularly cardiosphere-derived cells (CDCs) and umbilical cord blood-derived mononuclear cells (UCB-MNCs), in the treatment of HLHS. Methods Following PRISMA guidelines, a comprehensive search was conducted across major databases. Seven studies met the inclusion criteria, comprising randomized controlled trials, observational cohorts, and in vitro analyses. Quality appraisal was performed using RoB2, Newcastle–Ottawa, and SYRCLE tools. Results Stem cell therapy was associated with improvements in right ventricular ejection fraction, somatic growth, heart failure status, and psychosocial quality of life. CDCs showed favorable outcomes in both early and long-term follow-up, with reductions in scar burden, ventricular volume, and adverse events. Importantly, no major adverse effects such as arrhythmias, systemic infections, or tumor formation were reported. The use of allogeneic cells could extend beyond HLHS to other forms of congenital heart disease with right ventricular dysfunction, including tetralogy of Fallot, pulmonary atresia, and other single-ventricle variants. In vitro studies confirmed the regenerative capacity of pediatric-derived stem cells, with the highest potential in the first year of life. Conclusion Stem cell therapy demonstrates safety, feasibility, and potential efficacy in improving cardiac outcomes in HLHS. Larger, multicenter trials such as the APOLLON trial are warranted to validate these findings and support integration into standard clinical care.

Modern challenges require the implementation of interactive pedagogical technologies capable of not only enhancing the acquisition of theoretical knowledge but also developing students' clinical reasoning and practical skills. The relevance of this study is determined by the need to improve the quality of medical education in the context of rapid digitalization and the transition to a competency-based model of specialist training. Analysis of test results from 258 students revealed a clear positive trend in knowledge acquisition: the proportion of students demonstrating a high level increased from 24% at the pretest stage to 37.6% after completing the program, while the number of students with satisfactory results decreased from 37.2% to 6.2%. The data obtained confirm the effectiveness of the implemented workshop as an active educational method, especially for students with a low initial level of preparation. The workshop contributed not only to improved cognitive performance but also to the development of clinical reasoning, underscoring the importance of using interactive pedagogical technologies in medical education. The study's findings demonstrate the potential of pedagogical innovations adapted to local conditions as a basis for the widespread adoption of digital and blended learning approaches to improve the quality of professional training for future physicians.