bluuebunny/crossref_metadata_2025_split huggingface dataset:
An experience of staged treatment of gunshot wounds
Authors: Bogdanov S. B. , Tikunov D. V. , Shevchenko A. V. , Mukhanov M. L. , Zaytseva S. L. , Dutov V. S. , Sheshev A. R. 
Published: February 2025

The article describes clinical cases of successful treatment of gunshot wounds (shot) in the Trauma Department of the Scientific Research Institute – Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky" (Krasnodar, Russia). In the treatment of gunshot fractures, the recognized method is the use of external transosseous fixation devices, but in modern conditions it is possible to use various surgical techniques of one-stage and staged treatment. To prevent infectious complications, in addition to medications, VAC drainage and subsequently delayed autodermoplasty are recommended for victims with the most severe fractures.Purpose of a study: to select the most successful effective tactics for the treatment of non-standard clinical cases with ligamentous gunshot wounds of the extremities.Material and methods. Upon admission, all wounded underwent laboratory tests: general blood and urine tests, biochemical blood tests, immunological cytological studies, radiography and ultrasound examination (ultrasound) of the injured limb. Subsequently, surgical treatment of the wound, its vacuum therapy, plastic surgery with pedicle flaps and free skin autoplasty were performed in stages.Results. To replace the wound defect with exposure of deep anatomical structures, plastic surgery with skin-fat flaps was performed with an individual approach to the choice of the type of skin plastic surgery.Conclusion. The key factors for the success of the surgical results are consistency in treatment and active monitoring of the wound surface, aimed at early detection of potential complications in the postoperative period.
Analysis of hemodynamics indicators during laparoscopic cholecystectomy under epidural anesthesia
Authors: Yusufzoda O. K. , Safarzoda A. M. , Zikirzoda A. Kh. , Ibrokhimov Yu. Kh. , Ziyoev Sh. H. 
Published: February 2025

Aim. To assess hemodynamic changes during the use of epidural anesthesia in laparoscopic cholecystectomy.Materials and methods. The study included 184 patients who underwent surgery for cholelithiasis, with epidural anaesthesia in 105 cases and combined general anaesthesia in 79 cases. The majority of patients were female, 163 (88.6%), and 21 (11.4%) were male. The age of the patients ranged from 21 to 88 years. Anaesthetic risk was assessed according to the ASA (American Society of Anesthesiologists) classification. The epidural space was punctured in the sitting position between vertebrae Th8-Th11.Results. Patients were divided into two groups according to the chosen method of anaesthesia and haemodynamic characteristics. In the first group, laparoscopic cholecystectomy was performed under epidural anaesthesia. This group was further divided into two subgroups according to haemodynamic parameters: patients with a normokinetic type of circulation (20 individuals) and those with a hypokinetic type of circulation (19 individuals).The second group consisted of patients undergoing laparoscopic cholecystectomy under general endotracheal anaesthesia. The baseline haemodynamic status of these patients was characterised by a normokinetic type of circulation.Conclusion. A key advantage of epidural anaesthesia is the maintenance of spontaneous breathing throughout the operation. This allows adequate compensation for the adverse effects of capnoperitoneum in laparoscopic surgery
Treatment tactics for pregnant women with hemorrhagic stroke
Authors: Berdiev R. N. , Turdiboev Sh. A. 
Published: February 2025

Aim. To optimize delivery methods for pregnant women with hemorrhagic stroke.Material and methods. The study included 41 pregnant women aged 20 to 40 years with haemorrhagic stroke. All women underwent a general clinical examination, a haemostasis study, computed tomography, magnetic resonance imaging, cerebral angiography, consultations with a neurologist, neurosurgeon, anaesthesiologist and ophthalmologist.Results. Surgical intervention was required in 21 (51.2%) cases due to haemorrhage. The extent of the surgical intervention was as follows: - cranectomy with removal of intracerebral haematoma (IH) in 6 (28.6%) cases, osteoplastic trepanation with removal of IH in 3 (14.3%) pregnant women, trepanation with drainage of subacute and chronic IH in 4 (19. 1%), ventriculoperitoneostomy for occlusive hydrocephalus due to subarachnoid haemorrhage in 5 (23.7%) cases, and AA/AVM clipping in 3 (14.3%) of the remaining cases. Conservative management was performed in 20 (48.8%) cases. Residual effects of the transferred GI were observed in 22 (53.6%) women. Fundus examination revealed signs of intracranial hypertension in 18 (43.9%) pregnant women.Conclusion. Optimisation of the management of pregnant women who have had a haemorrhagic stroke with the participation of a group of specialists, timely diagnosis, adequate treatment of cerebral pathology allows to avoid errors in medical and obstetrical management, maintain pregnancy and safely increase the frequency of delivery of these patients through the natural birth canal. Timely detection and adequate treatment of brain pathology help reduce errors during treatment and delivery, which, in turn, supports the preservation of the gestational period and ensures the birth of a viable child.
On the issue of organizing active tuberculosis screening, taking into account key and individual vulnerabilities
Authors: Bobokhojaev O. I. , Saidova S. N. , Abdulloev N. N. , Gulomzoda B. Z. , Rasulov Yo. F. , Shukurov S. G. 
Published: February 2025

Aim. To analyze the main groups of patients with individual vulnerability to tuberculosis (TB), as well as key risk groups for the development of TB.Material and methods. This study identified and analyzed groups of patients with individual susceptibility to TB and key risk groups for the development of TB. WHO recommendations, TB program monitoring and evaluation reports, clinical guidelines and personal observations were used.Research results. The study identified the following vulnerable populations and key risk groups for tuberculosis: HIV-infected people, drug addicts, contacts, prisoners, labor migrants, patients with diabetes, viral hepatitis, mental illness, and decreed population groups. The methods and frequency of screening in each of these population groups are described.Conclusion. The findings showed that even with screening intervals as short as four months, 21% of patients were diagnosed with the disease at a moderately advanced stage, with a slightly lower percentage diagnosed at a late stage. For this reason, targeted screening among representatives of key high-risk groups for TB disease and vulnerable individuals allows for timely detection of cases of latent and active TB among them and improvement of clinical outcomes of the disease among these population groups.
Some issues of the clinical course of central nervous system damage in newborns
Authors: Vokhidov A. , Abdurakhmanova R. F. , Khokiroev D. S. , Abidjanova N. N. 
Published: February 2025

Aim. To study the impact of risk factors on the development of brain damage in the perinatal period.Material and methods. The work is based on a retrospective analysis of the medical documentation of the maternity hospital and the “mother and child” department of the state institution MC “Istiklol” in Dushanbe. The analysis included birth histories and developmental charts of newborns for the period from 2019 to 2021. In the process, data from statistical accounting form 32 “Report on medical care of pregnant women, women in labour, postpartum women and newborns” were used. Approved by the order of the State Statistics Service under the President of the Republic of Tajikistan No. 054 of 11 October 2013, the analysis covered the period from 2017 to 2021.Results and discussion. The highest number of children with birth injuries in the republic over the five analyzed years was recorded in 2018, with 2,020 cases. In 2021, the total number of children with birth injuries was 1,879.Over the five-year period, the incidence of birth injuries decreased by 20.9%; however, the number of affected children increased by 393 cases.In the city of Dushanbe, the highest number of newborns diagnosed with intrauterine hypoxia was recorded in 2019, with 962 cases, accounting for 7.4% of all children born sick or who developed illnesses. In 2021, a decrease in the proportion of children born sick was observed, with a reduction rate of 53.3%.Conclusions. An unstable trend in the reduction of the number of children born sick or who developed illnesses has been identified, with an increase in this indicator observed in 2021 compared to other years.The proportion of children who experienced intrauterine hypoxia has shown a clear downward trend over the fiveyear period. The number of children born with asphyxia in Dushanbe exhibits a pronounced tendency toward reduction.
Therapeutic and diagnostic solutions for the recurrence of acute adhesive small bowel obstruction
Authors: Gulzoda M. K. , Salimov D. S. , Mukhabbatzoda J. K. , Kholmatov P. K. , Ali-Zade S. G. , Nosiri K. N. , Kobilov I. I. 
Published: February 2025

Aim. To study the impact of risk factors on the recurrence rate of acute adhesive small bowel obstruction (AASBO) and to determine the indications for laparoscopic adhesiolysis.Materials and methods. To investigate the causes of AASBO recurrence, a statistical analysis of patients’ medical records was performed. The study included 50 patients who were divided into two groups according to the recurrence of the disease. The first group included 28 patients (56.0%) who experienced a recurrence of AASBO. The second group included 22 patients (44.0%) with no recurrence. This analysis allowed us to identify potential factors influencing the likelihood of AASBO recurrence and to assess the effectiveness of therapeutic measures aimed at preventing recurrences.Results and discussion. The primary factors associated with the risk of recurrence of AASBO include multiple episodes of AASBO in the patient’s history, elevated white blood cell levels, absence of colonic pneumatosis on radiographs of small bowel obstruction, significant volume of gastric contents drained by tube, and delayed transit of contrast medium through the small bowel. These indicators can serve as important predictors in determining the risk of disease recurrence and the need for additional medical intervention.Conclusion. The scale used in the study to assess the intensity of the adhesion process in the peritoneal cavity demonstrated its effectiveness. Based on the factors identified, a system for predicting the risk of recurrence after conservative treatment was improved, achieving an accuracy of 86%. This supports its recommendation for use in planning conservative therapeutic approaches.
Transfusionrelated acute lung injury (TRALI-syndrome) in critical states and its prevention measures
Authors: Bakhovadinov B. B. , Shumilina O. V. , Ashurzoda G. S. , Pevtsov D. E. , Muradov A. A. , Kubiddinov A. F. , Estrina M. A. 
Published: February 2025

Aim. To study the prevalence of transfusion-related acute lung injury (TRALI).Material and methods. A retrospective and prospective analysis of the medical histories of 3,750 women in labour and postpartum women with class III-IV (WHO) haemorrhage, 756 patients with acute gastroduodenal haemorrhage of ulcerative etiology, 150 victims of polytrauma complicated by massive haemorrhage was undertaken. In addition, the results of transfusion therapy of 7,325 oncological and haematological patients hospitalised at the Research Institute of Paediatric Oncology, Haematology and Transplantation named after R. Gorbacheva were analysed.Results and discussion. TRALI was diagnosed in 24 patients and “possible TRALI” in 5 obstetric patients, or 0.77% of cases. The frequency of TRALI and “possible TRALI” was 1 case per transfusion of 870.3 doses of donated blood and blood components. In surgical patients - 4 and 2 (0.79%) respectively (1 case per transfusion out of 765 doses of blood components). In polytrauma patients, the diagnosis of “possible TRALI” was made in 3 patients (2.0%). 4 cases of TRALI and 5 cases of “possible TRALI” were diagnosed in patients with oncological and oncohematological profiles. The frequency of TRALI and “possible TRALI” was 1 case per 16,155 transfusions.Conclusion. Transfusion of blood components is a high risk factor for the development of TRALI, especially from female donors with a history of multiple pregnancies and childbirth. In order to prevent TRALI, it is necessary to screen the blood of female donors for the presence of anti-HNA, anti-HLA antibodies, or to discontinue the clinical use of plasma-containing components of blood from female donors and to arrange for the preparation of platelet concentrate in an additional solution.
Intracranial infectious complications in patients with combined traumatic brain injury
Authors: Naimov S. R. , Rakhmonov Kh. J. , Kositov D. D. , Husainov E. S. 
Published: February 2025

Aim. To describe the structure of infectious complications and determine the risk of their formation in patients with combined TBI.Material and methods. The study was conducted at the Department of Neurosurgery and Combined Trauma of the Avicenna Tajik State Medical University at the State Medical Centre “Shifobakhsh” from 2020 to 2024. Participants were included according to the following criteria: hospitalisation in a national medical institution in the first 72 hours after TBI, age between 18 and 75 years, and stay in the intensive care unit (ICU) for more than 48 hours. A total of 124 patients with TBI were included.Research results. The acute phase of TBI is characterized by a significant prevalence of intracranial infectious complications, observed in 16% of cases. The most common infectious complication was meningitis, found in 18.7% of patients. The highest frequency of infectious complications was found in patients with category 4-8 intracranial injuries.Conclusion. Combined traumatic brain injury is associated with a high incidence of infectious complications, which were detected in 18.6% of study participants.
Evaluation of vitamin D levels in young patients with primary hyperparathyroidism combined with thyroid pathology
Authors: Niyazova N. F. , Tursunova S. B. 
Published: February 2025

Aim. To assess vitamin D levels in young patients with primary hyperparathyroidism (PHPT) combined with thyroid gland pathology.Materials and methods. A total of 48 patients with PHPT were studied from September 2021 to December 2023. The patients were divided into two groups: those with PHPT and those with primary hyperparathyroidism combined with thyroid pathology. Blood levels of parathyroid hormone (PTH), calcium, phosphorus, vitamin D, thyroid-stimulating hormone (TSH) and free thyroxine were measured. In addition, ultrasound and scintigraphy of the parathyroid and thyroid glands were performed.Results and discussion. . Patients with PHPT and thyroid pathology had lower calcium levels (2.49±0.07 mmol/L) and higher vitamin D levels (19.1±2.9 ng/mL) than patients with PHPT alone (2.71±0.1 mmol/L and 10.6±1.5 ng/ mL, respectively). These differences may be related to the compensatory function of the body in the presence of both conditions. Ultrasound showed differences in the degree of parathyroid hyperplasia between the two groups.Conclusion. Monitoring vitamin D and calcium levels is essential to accurately assess the condition of patients with PHPT, especially when combined with thyroid pathology. This will help to plan comprehensive treatment and reduce the risk of complications.
Assessment of the degree of carious process activity depending on the clinical form of congenital cleft lip and palate
Authors: Obidov S. A. , Ashurov G. G. , Karimov S. M. 
Published: February 2025

Aim. To study and identify the correlation between the clinical forms of congenital cleft lip and palate and the activity of the carious process during the periods of primary and transitional dentition.Material and methods. The study, which lasted 6 months, involved 75 children aged 5 to 12 years with various clinical forms of congenital cleft lip and palate. All examined children were found to have various dental pathologies of a carious and periodontal nature.Results and discussion. Children with isolated clefts of the upper lip and soft palate, exhibiting grade I and II carious activity, demonstrated a satisfactory level of oral hygiene, mild to moderate gingivitis, and a slight shift in oral pH toward acidity. In contrast, children with complete clefts of the lip and palate and grades II and III carious activity were found to have poor oral hygiene, severe gingivitis, and an insignificant shift in salivary pH toward acidity.Conclusion. In patients with complete clefts of the lip and palate and the highest levels of carious activity, the oral cavity’s buffering system operates in a consistently active mode, ultimately maintaining the stability of this parameter in mixed saliva.
Surgical treatment of hip joint diseases and prospects for the development of large joint arthroplasty in the Republic of Tajikistan
Authors: Rajabzoda M. M. , Juraev H. M. , Rajabzoda I. M. , Mamadiev Z. A. 
Published: February 2025

Aim. To analyse the surgical treatment of hip joint diseases and to present perspectives for the development of total joint arthroplasty in the Republic of Tajikistan.Material and methods. The material for this study comprised the medical records of patients hospitalized at the Republican Clinical Centre for Orthopaedics and Traumatology between 2009 and 2023. During this 15-year period, a total of 359 major joint replacements of the lower limbs were performed. The following parameters were analyzed based on the medical records: sex, age, diagnosis leading to the operation, method of anesthesia, patient’s place of residence, disability status after the operation, occurrence of complications and the number of revision joint replacements during the specified period.Results and discussion. The analysis showed that the majority of operated patients were diagnosed with idiopathic degenerative coxarthrosis. The second most common diagnoses were aseptic necrosis of the femoral head, dysplastic coxarthrosis, medial femoral fractures and their complications (such as nonunion or pseudoarthrosis), and congenital hip dislocation.Conclusion. Thus, although there has been a decline in the number of operations at the Republican Clinical Centre for Orthopaedics and Traumatology in certain years, the overall trend is a clear increase in the number of operations throughout the republic. This growth is observed not only in republican centers, but also in regional, city, central district hospitals and private medical centers.
Socio-demographic characteristics of pregnant women living in the city of Dushanbe
Authors: Yuldosheva M. U. , Rafieva Z. Kh. , Ashurova N. M. , Olimova F. Z. 
Published: February 2025

Aim. To study the characteristics of the obstetric history of pregnant women observed in urban health centers for the period 2013-2022.Material and methods. The study focused on pregnant women of reproductive age who were registered at urban health centres. The number of pregnant women, their parity and the time of their registration at the urban health centres were examined. Data from the individual medical records of pregnant women (form 111/y) were used for the analysis. The database of the Urban Reproductive Health Centre was used for the study.Results and discussion. The analysis of socio-demographic indicators shows an increase in the number of pregnant women. In the last 10 years, the number of pregnant women has increased by 1.4 times, from 18,070 in 2013 to 26,094 in 2022. There is a noticeable trend of decreasing registration of pregnant women after 22 weeks of pregnancy. The proportion of primiparous and multiparous women will also increase by a factor of 1.4 between 2014 and 2022.The frequency of high-parity pregnancies shows an upward trend from 2015 to 2020. However, from 2021 onwards, the proportion of women with high parity starts to decrease..Conclusions. The study of socio-demographic indicators of pregnant women in urban areas, observed by family doctors and obstetrician-gynaecologists at urban health centres, showed a trend towards an increase in the number of pregnant women, as well as in the proportion of primiparous and multiparous women. While the frequency of multiparous pregnancies reached significant levels, it has shown a decreasing trend over the last two years.
Reflections on introducing a carers’ forum in an intellectual disability secure service
Authors: Hickman Gareth , Kooner Gavin , Redwood Jannine 
Published: February 2025

Purpose:This paper reports on the development and introduction of a Carers’ Forum in an Intellectual Disability (ID) Secure Service. The current Forum was established as a supportive and interactive space for carer’ and relatives of current inpatient service users with specific recognition of the key role carers can play in the rehabilitation of service users with forensic histories. This article provides an overview of the process of establishing the Forum, brief evaluative data and reflects on the experience and learning points from developing such a resource in Secure contexts.Design/methodology/approach:The Carers’ Forum has been established and delivered over a 12-month period as a once monthly, one-hour, online session for anyone identifying as a Carer of a current inpatient service user in the Secure Service.Findings:Overwhelmingly Carers reported that they experienced the Forum as positive and beneficial. Personal reflections of the authors are offered on some of the impacts of such spaces for carers and some of the organisational and contextual challenges of establishing these Forums in Secure Services.
Fratura de fêmur proximal no esqueleto imaturo: relato de caso
Authors: Martins Milena Freitas , Ducatti Laura Brunelli , Souza Mateus Sartori de Oliveira , Silva Lucas Maluli Maluf , Souza Wagner Sartori de Oliveira , Resende Leonardo dos Reis , Moreschi Rodrigo Elias 
Published: February 2025

Introdução: A fratura diafisária do fêmur em crianças, geralmente causada por traumas intensos, requer diagnóstico por imagem e, muitas vezes, cirurgia para estabilização. A técnica de hastes elásticas intramedulares (TEN) é preferida, pois estabiliza a fratura de forma minimamente invasiva, permitindo rápida recuperação sem comprometer o crescimento ósseo. Estudos mostram que esse método reduz complicações e ajuda a prevenir discrepâncias no comprimento dos membros, sendo recomendado para o tratamento de fraturas femorais em esqueletos imaturos. Objetivo: Relatar o tratamento realizado em um caso de fratura de fêmur proximal no esqueleto imaturo com o uso de duas hastes flexíveis do tipo TEN e analisar o desfecho clínico do paciente. Metodologia: Trata-se de um relato de caso desenvolvido juntamente com revisão da literatura atual. Resultado: O paciente foi submetido ao tratamento cirúrgico com duas hastes intramedulares flexíveis TEN com diâmetro de 3mm, introduzidas sob escopia, e com tração cutânea. Conclusão: A técnica apresentada neste estudo é de fácil execução, menos invasiva e sem necessidade de manipulação do foco de fratura - comparada com outras possibilidades de tratamento, além de possibilitar uma redução adequada da fratura, independentemente do grau de desvio nos planos sagital e coronal e ainda preserva o aspecto biológico da consolidação.