International journal of medical sciences

Dry eye syndrome (DES) is a multifactorial ocular surface disorder that becomes increasingly prevalent among women during the climacteric period due to complex hormonal changes. Estrogen and androgen deficiencies associated with menopause affect the lacrimal and meibomian glands, leading to decreased tear production and instability of the tear film. As a result, affected women often experience symptoms such as ocular dryness, irritation, burning sensation, and visual fatigue, which can significantly impact daily activities and quality of life.
This study aims to investigate the primary causes and pathophysiological mechanisms of DES in climacteric women and to assess the effectiveness of various preventive strategies, including the use of artificial tears, nutritional supplements (e.g., omega-3 fatty acids), and hormone replacement therapy (HRT).
A total of 120 women aged 45 to 60 years were examined and divided into premenopausal, perimenopausal, and postmenopausal subgroups. Clinical tests, hormonal assessments, and patient-reported symptom questionnaires were used to evaluate tear function and ocular surface health.
The findings highlight a strong correlation between estrogen decline and the severity of DES symptoms. Preventive interventions demonstrated varying degrees of success, with the greatest improvement observed in patients who received early, individualized treatment.
The results of this study emphasize the need for increased awareness, timely screening, and comprehensive management of dry eye syndrome in menopausal women, which can ultimately reduce the burden of disease and improve their visual comfort and quality of life.

This article considers esophageal cancer as an urgent oncological problem in modern medicine. The main etiological factors, histological types, clinical symptoms, diagnostic methods and treatment approaches of the disease are analyzed. The differences between squamous cell carcinoma and adenocarcinoma, risk factors and modern diagnostic methods are highlighted. The prospects for immunotherapy and targeted therapy are also discussed. The article emphasizes the importance of early detection of esophageal cancer and preventive measures.

Uzbekistan is undergoing a fundamental transition toward sustainable development by embracing green energy and digital transformation as dual pillars of its national strategy. This study explores the synergy between renewable energy deployment and digital technologies in achieving a low-carbon, efficient, and inclusive energy future. Using policy analysis and sectoral data, the research highlights key developments such as solar and wind energy projects, smart grids, and digital energy management systems. The findings show that digitalization enhances energy efficiency, facilitates transparency, and optimizes resource allocation in the renewable sector. However, challenges remain, including outdated infrastructure, skills gaps, and regulatory fragmentation. The study concludes with policy recommendations to strengthen the green-digital nexus and accelerate Uzbekistan’s transition to a resilient and innovative energy economy.

This article is dedicated to the topic of changes in blood during pregnancy and biomarkers of pathology in the circulatory system of your heart, the importance of diagnosing and treating this disease. Heart disease is an important cause of maternal mortality in developing countries. Rheumatic heart disease is the cause of most abuse and deaths, and mitral stenosis is the most common lesion. In accordance with the purpose and objectives of the study, 110 pregnant women were examined. The results of the study showed that pregnant women with mitral stenosis show signs of systemic inflammation (increased levels of CRP, il-α), hypercoagulation (high levels of fibrinogen and d-enzyme) and impaired immune balance (decreased levels of il-10, increased IL-2). IL

Hemorrhagic stroke represents a significant cause of mortality worldwide, often accompanied by complex systemic pathophysiological changes. The adrenal glands, being highly vascularized organs crucial for stress response, may undergo specific pathomorphological alterations in patients with fatal hemorrhagic stroke. To investigate the pathomorphological changes in adrenal glands of patients who died from hemorrhagic stroke and analyze their relationship with clinical outcomes and mortality patterns. A retrospective autopsy study was conducted on 156 patients who died from hemorrhagic stroke between January 2020 and December 2023. Adrenal glands were systematically examined using histopathological analysis, immunohistochemistry, and morphometric evaluation. Clinical data including stroke severity, duration of illness, and comorbidities were correlated with pathological findings. Adrenal pathological changes were identified in 89.7% (140/156) of cases. Hemorrhagic changes were present in 62.8% of patients, with bilateral involvement in 23.1% of cases. Cortical necrosis was observed in 45.5% of patients, predominantly affecting the zona fasciculata. Medullary changes including chromaffin cell depletion were noted in 71.2% of cases. These changes appear to be related to the severity of cerebral injury and systemic complications, potentially contributing to the fatal outcome through impaired stress response mechanisms.

Preterm birth (PTB), defined as delivery before 37 completed weeks of gestation, remains a major global challenge and is one of the leading causes of neonatal morbidity and mortality. Despite advancements in perinatal care, the incidence of PTB has not significantly declined. Effective prediction and prevention strategies are essential for reducing its impact. This article reviews current approaches and recent innovations in the prediction and prevention of preterm birth, including risk factor analysis, cervical length measurement, biomarker screening, and pharmacologic and non-pharmacologic preventive strategies.

Hashimoto’s thyroiditis is a chronic autoimmune disease that primarily affects the thyroid gland, leading to progressive hypothyroidism. The condition occurs when the body’s immune system produces antibodies that attack thyroid tissue, resulting in inflammation and impaired hormonal function. Diagnosis is based on clinical symptoms, elevated TSH levels, low free thyroxine, and the presence of anti-thyroid antibodies. Treatment typically involves lifelong hormone replacement therapy with levothyroxine to normalize metabolic function.

The article presents a review and brief comparison of predominantly surgical methods of treatment of degenerative stenosis of the lumbar spinal canal based on foreign publications over the past 5 years. Also marked main current problems modern spinal neurosurgery

This study investigates the role and implementation of national values in organizing educational activities in primary schools. National values play a pivotal role in shaping students' moral, cultural, and social development during their early educational experiences. The article explores how the integration of these values into educational practices strengthens students’ identity, fosters respect for cultural heritage, and encourages responsible citizenship. Through classroom observations, interviews, and content analysis of school programs, the research highlights effective strategies for embedding national values into the fabric of primary education.

The article examines the issue of improving knowledge based on the syllogisms of Abu Ali ibn Sina. He defends the concept that through the influence of external forces, i.e. divine reason on human nature, thinking appears, then the desire to study, which ultimately leads to cognition. Through the construction of logical methods of study, in his opinion, a person can prepare a structure of the studied. Ordinary knowledge through the active use of reason can move to a higher stage of cognition.

In order to develop a new anti-inflammatory drug for the treatment of inflammatory diseases in pediatric practice, the pharmacological activity of CelAgrip and Ibuprofen on the development of exudation induced by histamine and carrageenan was studied in prepubertal animals. It was found that both drugs exhibited almost the same degree of anti-exudative effect, which was confirmed in an additional series of experiments using a model of aseptic peritonitis induced by acetic acid. It is believed that the action of the drugs does not show a pronounced dose dependence. Considering its low toxicity and absence of side effects, the use of CelAgrip in pediatric practice is recommended for the treatment of diseases in which inflammation plays a central role in the pathogenesis.

This scientific article provides information about the medical dressing room, which is used for dressing procedures in medicine, and about performing dressing procedures in it. It is known that today every surgical department should be well-equipped, meet the requirements of asepsis and current sanitary standards. The article provides useful concepts about the dressing room equipment, the procedure for using equipment, and dressing procedures. In addition, the 5 stages of performing dressing procedures are explained in detail.

This article analyzes the scientifically based effectiveness of physiotherapy methods in the restoration of post-stroke movement disorders. Based on medical literature, systematic reviews, and meta-analyses, the role of physiotherapy procedures in restoring motor activity, accelerating the return to independent life, and improving the quality of life of patients is highlighted. Scientific sources confirm that such approaches as Constraint-Induced Movement Therapy (CIMT), Mirror Therapy (MT), virtual reality (VR), and robotic therapy have shown effective results in post-stroke rehabilitation. The article also assesses the importance of starting early rehabilitation, an individual approach, and the role of a multidisciplinary rehabilitation team as important factors. The research results serve as a theoretical and practical basis for improving post-stroke physiotherapeutic approaches

A review of literature data on the role of cardiac conduction system pathology in the thanatogenesis of sudden death in alcoholic cardiomyopathy and coronary heart disease from a forensic medical perspective is provided. Modern data on the main pathological changes in the heart's conduction system in alcoholic cardiomyopathy and coronary heart disease are presented. Modern and historical aspects of pathology in the conducting system of the heart are highlighted. Further ways to develop a more detailed study of the thanatogenesis of sudden death in ACMP and coronary artery disease have been identified.

Cardiovascular diseases (CVD) are currently the leading cause of death worldwide. Millions of people die or become disabled from these diseases every year. Recent epidemiological studies have shown that although CVD develops earlier in men, its incidence increases in women after menopause. This is likely due to hormonal differences, lifestyle factors, stress levels, and access to health care.

The article analyzes heart diseases, their types, causes of development and symptoms. Extensive information on the risk factors of these diseases and methods of their prevention is presented. Methods of treating heart diseases, modern approaches to medicine are also presented.

According to the World Health Organization (WHO), more than 18 million people die from cardiovascular diseases every year. This is approximately 32% of the total number of deaths. About 85% of them occur as a result of a heart attack or stroke.

Secondary strabismus is an acquired disorder of eye coordination and position caused by multiple systemic, neurological, and mechanical factors. This pathology differs from congenital strabismus by its later onset, frequent development of diplopia, and impaired binocular vision. The article analyzes the main etiologic factors, including traumatic brain injury, vascular lesions, neurological disorders, ophthalmic surgery, and dysfunction of the oculomotor muscles and cranial nerves. Modern diagnostic methods, such as visual assessment, prismatic correction, neuroimaging, and electrophysiological tests, are considered. Attention is paid to therapeutic strategies: orthoptic rehabilitation, botulinum toxin administration, surgical methods, and systemic treatment of the underlying disease. Particular importance is attached to a multidisciplinary approach and early intervention aimed at optimizing visual functions and improving the quality of life of patients.

Metabolic syndrome is a combination of pathological conditions, including insulin resistance, arterial hypertension, hyperlipidemia, and abdominal obesity, which significantly affect various body systems. One of the important aspects of metabolic syndrome is its impact on eye health, especially on the development of inflammatory diseases such as conjunctivitis. Conjunctivitis against the background of metabolic syndrome can have various clinical manifestations, including redness, itching, tearing, and eye swelling. The pathogenesis of these diseases includes both the direct effect of metabolic disorders and the secondary weakening of immune defense. Endocrine and metabolic disorders contribute to changes in the structure of tear fluid, which increases susceptibility to inflammation and infections.

A comprehensive approach to treating conjunctivitis against the background of metabolic syndrome includes both systemic and local therapeutic methods. The most important areas of treatment are the correction of metabolic disorders using drugs aimed at reducing blood sugar levels, improving lipid metabolism, and normalizing blood pressure. Local treatment of conjunctivitis includes the appointment of anti-inflammatory and antiseptic medications, as well as the use of medications to improve the condition of the tear film. Thus, effective treatment of conjunctivitis in patients with metabolic syndrome requires an individual approach, which includes both the correction of the underlying disease and the use of specific therapy to reduce inflammation and prevent complications.

Chronic cystitis pleuritic inflammatory syndrome (CCPIS) is a rare and poorly understood condition involving persistent inflammation of both the bladder and pleura. This article explores the long-term consequences of CCPIS, including chronic pain, respiratory complications, urinary system dysfunction, mental health challenges, increased risk of comorbid conditions, and potential for organ damage. Due to its complex and multisystemic nature, CCPIS can significantly reduce quality of life and functional ability over time. The article emphasizes the importance of early diagnosis, comprehensive treatment, and multidisciplinary care to manage the condition effectively and prevent lasting complications.

Endometrial hyperplastic processes represent a group of proliferative conditions of the endometrium that range from benign glandular-stromal overgrowth to precancerous atypical hyperplasia. They are considered one of the most significant gynecological disorders due to their potential progression to endometrial carcinoma. Early diagnosis and adequate treatment are essential to prevent malignant transformation while maintaining reproductive potential. Recent advancements in imaging techniques, molecular diagnostics, and fertility-preserving treatment options have significantly transformed the clinical approach to endometrial hyperplasia. This article provides a comprehensive overview of the current strategies for early detection and treatment, emphasizing personalized medicine and evidence-based management.

The article analyzes the theme of spirit and tolerance in the poetry of Karakalpak poet Abat Kramov. His work is compared with the poetry of Muhammad Yusuf and Yesengali Raushanov, revealing common motifs in the literature of independence.

The kidney is a vital organ responsible for maintaining fluid and electrolyte balance, excreting metabolic waste, and regulating blood pressure. Histologically, the kidney consists of nephrons, each composed of a renal corpuscle and tubular system, supported by interstitium and vasculature. Pathological processes such as glomerulonephritis, diabetic nephropathy, and chronic kidney disease disrupt the delicate microanatomical organization, leading to functional impairment. This article reviews the normal histological architecture of the kidney and highlights characteristic pathological changes, emphasizing their clinical and diagnostic relevance.

The liver is one of the largest and most metabolically active organs in the human body, playing a vital role in maintaining homeostasis. This article provides a comprehensive anatomical overview of the liver, describing its macroscopic structure, microscopic organization, vascular supply, and functional significance. The study also highlights clinical correlations of hepatic anatomy, emphasizing its importance in medical education and surgical practice.

Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide, requiring deeper investigation through experimental approaches. The purpose of this study is to review the most relevant models of experimental atherosclerosis and their contribution to understanding disease pathogenesis and treatment. Different experimental methods, including dietary induction, genetic modifications, and vascular injury, have been analyzed. Results demonstrate that while animal models provide essential insights into molecular and cellular mechanisms of atherosclerosis, each approach has unique limitations. The findings highlight the necessity of selecting models based on specific research objectives to ensure translational value.

This article is devoted to the genetic and epigenetic causes of Down syndrome, as well as modern medical and pedagogical methods of treatment. The article analyzes the genetic mutations of Down syndrome, manifestations of the disease in childhood and adolescence and their impact on the quality of life. The accuracy of symptoms, diagnostic methods (in situ hybridization, karyotyping) and the importance of early detection are considered. The effectiveness of drugs, physiotherapy, speech therapy, inclusive education and family counseling as methods of intervention is also assessed. The experimental part analyzes the metrics of diagnosis and rehabilitation based on clinical observations and social surveys. The discussion section compares with the scientific literature, considers the advantages and limitations of treatment methods, as well as prospects for further research. The conclusions note the need to strengthen the integrative approach to improve the quality of life of children with Down syndrome.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by difficulty maintaining attention, hyperactivity, and impulsivity. Its prevalence among children reaches 5–15%, while in adults it remains at 6–7%. These disorders are caused by a complex interaction of genetic (up to 80%) and environmental factors. Pathogenesis includes disorders of the dopaminergic and noradrenergic systems — the prefrontal cortex and basal ganglia: this is ensured by the genes of dopamine transporters and receptors (DAT1, DRD4, etc.). Diagnosis is based on the DSM 5 criteria using scales (e.g., the Conners questionnaire). Treatment involves a multidisciplinary approach: psychostimulants (methylphenidate, amphetamines), non-steroidal drugs (atomoxetine, reboxetine), psychotherapeutic and behavioral methods. In adults, ADHD is associated with a higher risk of comorbid disorders, due to poor concentration and impulsivity, professional and social functioning suffers. The purpose of the article is to present the current state of knowledge about ADHD: pathogenesis, clinical features, diagnosis and therapy.

This article discusses the technology of obtaining dry extract from the leaves of rosemary (Rosmarinus officinalis L.), one of the medicinal plants. The pharmacological significance of biologically active compounds contained in rosemary, including essential oils, phenolic acids, flavonoids and diterpenoids, is analyzed. The process of producing dry extract includes the stages of extraction, filtration, concentration and drying. Scientifically based recommendations are given on the selection of the optimal solvent in the production technology, determination of extraction parameters and ensuring the preservation of biologically active substances.

Advancements in diagnostic radiology have significantly enhanced the detection, characterization, and management of urogenital pathologies. This overview highlights contemporary imaging modalities utilized in evaluating diseases of the urinary and reproductive systems, emphasizing their clinical applications and diagnostic efficacy.

Coxarthrosis (hip osteoarthritis) is a chronic degenerative joint disease that, in stages III–IV, is characterized not only by mechanical destruction of cartilage and bone but also by significant immunological alterations. Elevated pro-inflammatory cytokines, activation of macrophages and lymphocytes, as well as systemic immune imbalance, play an important role in disease progression. Recognition of these immunological aspects may contribute to the development of new diagnostic markers and targeted therapies.

The aim of this study was to analyze the current epidemiological situation of measles, its clinical course, and the effectiveness of preventive measures. The study was based on epidemiological surveillance of measles cases registered in the Republic of Uzbekistan during 2020–2024. The clinical course was evaluated using data from 120 patients treated in the measles ward of the 3rd Clinic of the Tashkent Medical Academy. The main symptoms of the disease, distribution by age groups, and the relationship with vaccination coverage were analyzed using statistical methods. According to the results, measles was most frequently observed in children aged 1–5 years (68%). The most common clinical signs were fever (95%), rash (100%), cough (85%), and conjunctivitis (70%). The incidence was significantly lower in regions with high vaccination coverage (p<0.05). These findings indicate that measles still remains a pressing health problem. It has been proven that increasing vaccination coverage can reduce the incidence of the disease.

In this article, the author studied the results of plastic surgery of cicatricial deformities of the cranial vault with the consequences of burns that were in the department of reconstructive and plastic surgery. The method of intraoperative balloon stretching was used in 23 patients. They are included in the main group. The control group consisted of patients who underwent the acute dermotension method. As a result of plastic surgery, 21 (91.3%) patients in the main group showed good results, while 11 (64.7%) patients in the control group.

Forensic medicine, as a specialized branch of medical science, plays a crucial role in the administration of justice by applying medical expertise to legal questions. It bridges the gap between medicine and law, providing objective evidence that supports criminal investigations, civil disputes, and public health protection. This article examines the historical development of forensic medicine, its scope and methodologies, and its contributions to contemporary judicial systems. Particular emphasis is placed on forensic pathology, toxicology, injury analysis, and the use of DNA profiling. Challenges and future prospects are also discussed, highlighting the importance of multidisciplinary collaboration and scientific advancement in strengthening justice and social trust.

Intraepithelial lymphocytes (IELs) represent a unique population of immune cells embedded within the epithelial layer of the gastrointestinal tract. Their histological distribution, morphological features, and immunological roles are essential for maintaining mucosal homeostasis and providing first-line defense against pathogens. This article aims to explore the structural characteristics, histological localization, and functional implications of IELs, integrating current knowledge from experimental and clinical studies.

This article explores the pragmatic functions of proverbs in English and Uzbek discourse, focusing on how these concise expressions convey meaning beyond their literal content. Taking a cross-cultural perspective, this study analyzes how proverbs are used in communication to advise, persuade, criticize, and reinforce social norms. The findings reveal that while English proverbs often reflect individualism, practicality, and efficiency, Uzbek proverbs emphasize collectivism, morality, and respect for tradition. Through this comparative analysis, the article highlights both universal pragmatic strategies and culturally specific features, demonstrating the essential role of proverbs in shaping discourse and cultural identity.

Non-alcoholic fatty liver disease (NAFLD) is a major hepatological disorder characterized by excessive fat accumulation in hepatocytes without significant alcohol consumption. It represents the most common cause of chronic liver disease worldwide, affecting nearly one quarter of the global population. NAFLD encompasses a spectrum ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. This article aims to analyze the pathogenesis, histopathological features, and clinical significance of NAFLD, with emphasis on diagnostic strategies and therapeutic challenges.

:Iron deficiency anemia (IDA) is the most prevalent nutritional disorder in children worldwide, significantly impacting growth, cognitive development, and overall health. The condition arises from inadequate dietary intake, impaired absorption, or increased iron requirements during periods of rapid growth. This article reviews the pathophysiological mechanisms of IDA in children, its clinical manifestations, and current strategies for diagnosis and management. Evidence from recent studies indicates that while oral iron supplementation remains the first-line treatment, adherence and gastrointestinal side effects pose challenges. A deeper understanding of iron metabolism in childhood highlights the importance of preventive strategies, including dietary interventions and fortification programs.

The ecological crisis of the Aral Sea has led to a complex of adverse environmental factors, including water and soil salinization, contamination with pesticides and heavy metals, and frequent dust and salt storms. This study aims to investigate the influence of these specific environmental factors on the prevalence and structure of dentoalveolar anomalies (DAA) in children residing in the Aral Sea region. A comparative cross-sectional study was conducted involving 450 children aged 7 to 14 years from the Karakalpakstan region (main group) and 450 children from a conventionally clean area in the Tashkent region (control group). Clinical dental examinations were performed to assess the state of the dentoalveolar system using the Angle classification and other metric measurements. A questionnaire was used to collect data on residential history, dietary habits, source of drinking water, and prevalence of respiratory diseases. The results revealed a significantly higher prevalence of DAA in the main group (88.2%) compared to the control group (46.5%) (p < 0.001). The structure of anomalies in the Aral Sea region was dominated by sagittal anomalies (Class II and III malocclusion), vertical anomalies (deep bite and open bite), and dental crowding. A strong correlation was found between the presence of DAA and factors such as high water salinity, chronic exposure to dust storms, and a diet deficient in essential micronutrients. In conclusion, the complex environmental degradation in the Aral Sea region acts as a significant risk factor, contributing to the high prevalence and specific patterns of dentoalveolar anomalies in the pediatric population. These findings underscore the need for targeted public health interventions, including early dental screening, nutritional support programs, and measures to improve water quality in the affected region.

Objective: To assess the need for orthodontic treatment among children and adolescents in the Republic of Karakalpakstan, an ecologically challenging region, and to identify the distribution of malocclusion severity.

Methods: A cross-sectional epidemiological study was conducted on a sample of 1200 schoolchildren aged 12 to 15 years from various districts of Karakalpakstan. The need for orthodontic treatment was evaluated using the Index of Orthodontic Treatment Need (IOTN), which consists of the Dental Health Component (DHC) and the Aesthetic Component (AC). Clinical examinations were performed by calibrated examiners. Data on demographic characteristics were also collected.

Results: The results indicated a high level of need for orthodontic treatment. According to the DHC of the IOTN, 45.8% of the examined children were classified as having a definite need for treatment (grades 4 and 5), 35.2% had a borderline need (grade 3), and only 19.0% had little to no need (grades 1 and 2). The most common occlusal traits leading to a high DHC score were increased overjet, crossbites, and severe crowding. The AC assessment revealed that 38.5% of children were dissatisfied with their dental appearance (scores 8-10).

Conclusion: There is a substantial objective and subjective need for orthodontic care among children and adolescents in the Republic of Karakalpakstan. These findings highlight the necessity for developing and implementing a regional public health program focused on orthodontic screening, prevention, and accessible treatment to address the high prevalence of malocclusion in this vulnerable population.

Objective: To conduct a comparative analysis of the level of medical literacy regarding cervical cancer (CC) and to identify the prevalence of its main risk factors among women living in different districts of the Republic of Karakalpakstan. Methods: A cross-sectional anonymous survey was conducted among 1,500 women aged 25-49. A specially designed questionnaire was used to assess awareness of CC, human papillomavirus (HPV), screening methods (Pap test, HPV test), HPV vaccination, and key risk factors (smoking, early sexual debut, number of partners). Statistical analysis was performed to compare data between urban (Nukus city) and rural populations. Results: The study revealed a generally low level of medical literacy on CC issues. Only 35% of respondents were aware of the link between HPV and CC. Women in rural areas demonstrated significantly lower awareness compared to urban residents (p < 0.001). A high prevalence of risk factors was identified: 28% of respondents were smokers, and 45% reported an early sexual debut (before age 18). A significant negative correlation was found between the level of medical literacy and the presence of behavioral risk factors. Conclusion: There is a critical need to increase medical literacy about cervical cancer and its prevention among women in Karakalpaikstan, with a particular focus on rural areas. The findings justify the need for targeted educational programs and the development of accessible screening services to reduce the incidence and mortality of cervical cancer in the region.

Hemorrhagic vasculitis (Henoch-Schönlein purpura) is the most common manifestation of inflammation of the small vessels and may result in severe complications if nephropathy develops. The aim of this study is to investigate the correlation between immune-hematological markers and the development of nephropathy. Literature review demonstrates that IgA immunoglobulins, the complement factors, cytokine levels, and alterations in platelet function are determinants of nephropathy development. Results indicate that deposition of IgA deposits in glomeruli, decreased C3 and C4 complement levels, increased levels of IL-6 and TNF-α cytokines, and platelet function disorders correlate directly with nephropathy development.

Objective: To conduct a comparative analysis of the level of medical literacy regarding cervical cancer (CC) and to identify the prevalence of its main risk factors among women living in different districts of the Republic of Karakalpakstan. Methods: A cross-sectional anonymous survey was conducted among 1,500 women aged 25-49. A specially designed questionnaire was used to assess awareness of CC, human papillomavirus (HPV), screening methods (Pap test, HPV test), HPV vaccination, and key risk factors (smoking, early sexual debut, number of partners). Statistical analysis was performed to compare data between urban (Nukus city) and rural populations. Results: The study revealed a generally low level of medical literacy on CC issues. Only 35% of respondents were aware of the link between HPV and CC. Women in rural areas demonstrated significantly lower awareness compared to urban residents (p < 0.001). A high prevalence of risk factors was identified: 28% of respondents were smokers, and 45% reported an early sexual debut (before age 18). A significant negative correlation was found between the level of medical literacy and the presence of behavioral risk factors. Conclusion: There is a critical need to increase medical literacy about cervical cancer and its prevention among women in Karakalpaikstan, with a particular focus on rural areas. The findings justify the need for targeted educational programs and the development of accessible screening services to reduce the incidence and mortality of cervical cancer in the region.

Introduction: Childhood bronchial asthma represents a significant and growing public health challenge in Uzbekistan, contributing to substantial morbidity and socioeconomic burden. Delays in diagnosis and suboptimal prevention strategies at the primary healthcare level exacerbate the problem. A coordinated, state-level strategic approach is essential for effective long-term control. This article analyzes the strategic importance of national programs for the prevention and early detection of childhood asthma in Uzbekistan. Methods: This study employs a health policy analysis framework. It involves a systematic review of international guidelines from the World Health Organization (WHO) and the Global Initiative for Asthma (GINA), an analysis of successful national asthma programs in other countries, and an examination of Uzbekistan's current healthcare priorities as outlined in the "New Uzbekistan" Development Strategy for 2022-2026. A strategic framework was synthesized based on these data sources to identify key intervention areas for a national program. Results: The analysis identified two core strategic pillars for a comprehensive national program: (1) Primary Prevention and (2) Early Detection and Management. The Primary Prevention pillar encompasses three key domains: strengthening environmental controls to reduce exposure to pollutants and allergens; launching national public health campaigns to improve health literacy regarding asthma risk factors; and promoting healthy nutrition, including breastfeeding. The Early Detection pillar focuses on four critical areas: enhancing the capacity of primary healthcare professionals through continuous medical education; expanding access to objective diagnostic tools like spirometry in primary care settings; implementing a national screening program for high-risk children; and integrating digital health technologies and clinical decision support systems to standardize care. Conclusion: A comprehensive, government-led national program is critical to fundamentally improving childhood asthma outcomes in Uzbekistan. Such a program, built on the pillars of robust primary prevention and systematic early detection, has the potential to reduce the incidence and severity of the disease, decrease long-term healthcare costs, and improve the quality of life for millions of children. Successful implementation will require strong political commitment, multi-sectoral collaboration, and sustained financial investment.

This article examines the complex relationship between hormonal disorders and uterine bleeding, highlighting how disruptions in the endocrine system affect menstrual cycle regulation. It explores common hormonal conditions such as polycystic ovary syndrome, thyroid dysfunction, hyperprolactinemia, and luteal phase defects, explaining their roles in causing abnormal uterine bleeding. The article also discusses diagnostic approaches and treatment options aimed at restoring hormonal balance and managing bleeding disorders. Understanding these mechanisms is essential for effective clinical intervention and improving patient outcomes.

Twin pregnancies, encompassing both monozygotic (MZ) and dizygotic (DZ) types, represent a unique model for studying the interplay between genetic and epigenetic factors due to shared or divergent intrauterine environments. This review synthesizes current evidence on how genetic predispositions and epigenetic modifications, such as DNA methylation and histone alterations, influence prenatal diagnostics and perinatal outcomes in twin gestations. Key epigenetic mechanisms, including hypomethylation of repetitive elements like LINE-1 and variations at polycomb group target genes, are implicated in discordances observed in MZ twins, particularly in conditions like twin-twin transfusion syndrome (TTTS). Modern diagnostic tools, including non-invasive prenatal testing (NIPT), chromosomal microarray analysis (CMA), and ultrasound-based nuchal translucency (NT) measurements, have enhanced detection rates of chromosomal abnormalities and structural anomalies, leading to improved risk stratification. Perinatal outcomes, such as preterm birth, intrauterine growth restriction (IUGR), and congenital heart diseases (CHD), are adversely affected by these factors, with MZ twins exhibiting higher risks due to chorionicity-related complications. Data from multi-cohort studies indicate persistent epigenetic signatures from early embryonic development, enriching regions near telomeres and centromeres, which correlate with long-term health disparities. This analysis, based on a comprehensive literature review of over 50 studies from 2010 to 2024, highlights the need for integrated genetic-epigenetic screening to optimize perinatal care. Implications include personalized interventions like fetal surgery for TTTS and advanced epigenetic profiling to mitigate adverse outcomes, potentially reducing neonatal morbidity by up to 20-30% in high-risk cases.

Objective: To evaluate the effectiveness of an integrated program for early diagnosis and a multidisciplinary team (MDT) approach in managing children with cystic fibrosis (CF) in Uzbekistan, aiming to improve clinical outcomes. Methods: A retrospective cohort study was conducted, analyzing the medical records of CF patients diagnosed at a national referral center. Patients were divided into two groups: Group 1 (n=50), diagnosed before the implementation of the new program (2015-2018), and Group 2 (n=55), diagnosed and managed under the new program (2019-2022), which included standardized diagnostic algorithms (sweat test, genetic testing) and coordinated care from an MDT (pediatric pulmonologist, gastroenterologist, physiotherapist, nutritionist). Key outcomes, including age at diagnosis, nutritional status (BMI-for-age z-score), and pulmonary function (FEV1%), were compared between the groups. Results: The mean age at diagnosis was significantly lower in Group 2 (0.8 ± 0.5 years) compared to Group 1 (4.2 ± 2.1 years) (p < 0.001). At age 8, children in Group 2 demonstrated significantly better clinical outcomes: a higher mean BMI-for-age z-score (-0.5 ± 0.4 vs. -1.8 ± 0.7, p < 0.001) and a higher mean FEV1% predicted (85% ± 10% vs. 68% ± 15%, p < 0.001). The annual rate of pulmonary exacerbations requiring hospitalization was also lower in Group 2 (0.7 per year) compared to Group 1 (2.5 per year). Conclusion: The implementation of a structured program for early diagnosis combined with a multidisciplinary approach to care significantly improves the nutritional status, and pulmonary function, and reduces morbidity in children with cystic fibrosis in Uzbekistan. These findings strongly support the nationwide expansion of newborn screening for CF and the establishment of specialized MDT centers to improve long-term prognosis.

Oxidative stress represents a critical imbalance between the generation of reactive oxygen species (ROS) and the capacity of antioxidant defenses, leading to cellular and tissue damage. This phenomenon has been implicated in the pathogenesis of various diseases, including cardiovascular disorders, neurodegeneration, cancer, and chronic inflammation. This study provides an overview of the molecular and pathophysiological mechanisms underlying oxidative stress and evaluates its role in disease progression. By reviewing experimental and clinical findings, the article highlights potential therapeutic strategies aimed at modulating oxidative pathways to prevent or mitigate disease outcomes.