Sixty-nine postpartum women with postpartum uterine inflammation (mean age 25.8 ± 2.2 years) were examined in the postpartum department of the 3rd Minsk City Clinical Hospital named after E. V. Klumov.  The control group consisted of 19 postpartum women with a normal postpartum period (mean age 24.4 ± 2.6 years).
The study group included 34 patients who received drug therapy according to the treatment protocol in combination with a course of ovomin (1 ml of a solution containing 12,000 ATE, diluted in 250 ml of saline), administered intravenously by drip once daily for 7 days. The comparison group consisted of 35 women in labor who received drug treatment according to the protocol (intravenous drip infusion of 100 ml of 0.5 % metronidazole solution 3 times a day and 2 g of ciprofloxacin 400 mg once a day) for 7 days. All patients underwent uterotonic therapy. It was found that the inclusion of ovomine in the complex therapy of uterine inflammation contributes to an increase in its effectiveness, which is characterized by the normalization of clinical and laboratory parameters and a decrease in the severity of clinical symptoms of the disease from 52.7 ± 10.05 to 10.3 ± 2.65 points (p = 0.029), which was significantly different from the corresponding value after treatment in the comparison group, which was 19.0points (p = 0.011). The treatment effect per woman in labor after complex treatment was 1.25 times higher than the effectiveness of conventional therapy (p = 0.012). Intravenous drip administration of 1 ml of ovomin, a solution containing 12,000 ATE and diluted in 250 ml of saline, once daily for 7 days has a pronounced anti-inflammatory and anti-lysosomal effect, as evidenced by a direct correlation between uterine tone (based on cavity size)  and CRP levels (r = 0.086, p = 0.0001), as well as serum cathepsin expression (r = 0.68, p = 0.021), reflecting the high effectiveness of ovomin in the complex treatment of patients with inflammatory uterine diseases.

The comparative analysis of nosocomial infection contaminations at hardware-assisted ventilated patients in two intensive care units of MSPCSTH and the estimation of sensitivity of the given microorganisms to various antibiotics is presented in this article. A number of antibiotics are recommended as adequate empirical starting therapy at VAP.

Objective. To evaluate an implant-independent stabilization method for chronic anterolateral ankle instability using a palmaris longus tendon autograft. 
Materials and methods. A clinical series of 27 patients treated in 2022–2025 was analyzed. The method included two-mini-incision palmaris longus harvesting, fibular tunnel formation in a superior-inferior and anteriorposterior direction, graft passage as a loop and transosseous fixation to the lateral talar surface without anchors or screws. Outcomes were assessed with AOFAS, Karlsson-Peterson, FAAM-ADL, FAAM-Sport and VAS pain scores at 6, 12 and 24 months. 
Results. AOFAS improved from 63.2 ± 6.4 preoperatively to 89.1 ± 4.7 at 12 months and 90.0 ± 4.5 at 24 months. Karlsson–Peterson improved from 51.8 ± 6.8 to 86.7 ± 5.6 and 87.5 ± 5.4, FAAM-ADL from 59.4 ± 8.1 %  to 89.2 ± 5.9 % and 90.3 ± 5.6 %, FAAM-Sport from 54.8 ± 9.2 % to 87.3 ± 6.4 % and 88.2 ± 6.2 %, while VAS  pain decreased from 6.4 ± 1.2 to 1.4 ± 0.8 and 1.3 ± 0.7. Return to activity was achieved in 24/27 patients (88.9 %) at 12 months and 25/27 (92.6 %) at 24 months. No revision surgery, common peroneal nerve injury or clinically significant donor-hand deficit was recorded. 
Conclusion. The palmaris longus method appears to be a reproducible option for chronic anterolateral ankle instability when local ligament tissue is insufficient and preservation of peroneal tendons is required.

It is a firmly established fact that obstructive sleep apnea syndrome (OSAS) is the etiologic factor of atrial fibrillation (AF). Inflammation plays a significant role in the pathogenesis and progression of AF. The prognostic potential of some laboratory-hematologic indices of inflammation in patients with AF and OSAS phenotype remains a matter of debate. In the present article, based on regression analysis of clinical, instrumental indices and laboratory biomarkers, the authors have been performed on the prediction of AF progression in particular group of patients with concomitant OSAS by developing composite risk mathematical model. The calculated  value of 0,499 and more predicts a high probability of АF recurrence with sensitivity of 82,35 % and specificity  of 86,21 %. This personalized approach helps to solve the problem of predicting AF recurrence in a particular patient and makes it possible to guide the doctor to choose the optimal reasonable therapy to maintain the sinus rhythm in AF patients with concomitant OSAS.

Reconstructive restorative surgery is considered by coloproctologists and patients as the final stage of treatment following obstructive resection of the colon. The relevance of this issue increases every year. This is due to several factors: the growing number of colon surgeries that require a temporary stoma, improved survival rates of patients after cancer treatment, and a shift in the focus of modern medicine toward not only preserving life but also ensuring its high quality. In recent years, evidence has emerged regarding the role of the colonic microbiota in the process  of intestinal wall remodeling, which affects the success of reconstructive restorative surgery.

Symptoms of chronic rhinitis significantly reduce quality of life and ability to work in patients. Inability of full nasal breathing disrupts sleeping and daytime activity and can lead to snoring and obstructive sleep apnea as well as acute and chronic diseases of other ENT organs. One of the disease progression aspects is the suppression of respiratory epithelium cilia of the nasal cavity and impaired mucociliary clearance (MCC) both as a result of chronic nasal obstruction and the ciliostatic effect of topical decongestants which patients often use unsupervised for self-treatment. 
The aim of the study was to evaluate the impact of vasomotor rhinitis on the quality of life of young patients through a comprehensive analysis of subjective data (SNOT-22 questionnaire) in relation to objective indicators of mucociliary clearance function impaired. 
Materials and methods: 108 young adults (18–25 years old) were examined: 55 with a diagnosis of vasomotor rhinitis (study group) and 53 without ENT pathology (control group). All participants underwent a comprehensive examination including a quality-of-life assessment using the validated SNOT-22 questionnaire (RUS) and an objective assessment of the MCC- functional state using the timed saccharin test. 
Results: the quality of life in young patients with vasomotor rhinitis was reduced by 7 times (Me (LQ; UQ) = 54 (43; 64) points) compared to the control group (Me (LQ; UQ) = 8 (0; 20) points; p < 0.001) and a statistically significant violation of MCC was established: the time of the saccharin test was Me (LQ; UQ) = 23.17 (16.35; 31.17) minutes which is 2.5 times higher than the control group Me (LQ; UQ) = 9.3 (5.13; 12.79) minutes, p < 0.001.  A strong direct correlation was established between subjective and objective indicators (Spearman coefficient  ρ = 0.78; p < 0.001) in the study group: the disturbance of MCC more pronounced and the quality of life of the patient with vasomotor rhinitis is worse. 
Conclusion. The combined use of the SNOT-22 questionnaire with the saccharin test is an informative method for assessing of vasomotor rhinitis severity and can be recommended as a screening patient to early diagnosis and timely correction of identified disorders.

The article presents an analysis of morbidity and disability rates associated with diseases of the musculoskeletal system and connective tissue among the adult and child population of the republic. The relevance of early diagnosis, complex treatment and medical rehabilitation of children with diseases of the musculoskeletal system is shown.  The article presents the experience of rehabilitation of children with spinal deformities at a sanatorium boarding school and the use of a computerized diagnostic complex to assess the effectiveness of the measures taken. 

The aim of the study was to examine hystologic changes of healing of an ileileoanastomosis made by interrupted mattress seromusculosubmucosal sutures in 30 days after a surgery in the experiment.
Material and methods. During experimental surgery on 6 dogs ileoileoanastomoses were perfomed by handle interrupted mattress seromusculosubmucosal suture using vicryl 000 with atraumatic needles. In terms of 2, 6 and 30 days after the operation 101 hystologic specimens were examined in order to investigate the healing of the anastomotic wounds, inflammation and terms of mucosal membrane healing.
Results. On 2 day after the surgery massive cells infiltration and signs of productive inflammation around the suture material were observed. In 57 % specimens initial epithelization signs were determined. On 6 days after the operation anastomotic wound epithelization had been ended. Massive lymphoid and plasmatic cells infiltration with some neutrophil leucocytes and signs of productive inflammation around suture material spreading on submucosal membrane were observed. On 30 days after the surgery anastomotic wound was not determined on macroscopic study. Wound epithelization with signs of productive inflammation around the suture material and growth of connective tissue were determined.
Conclusion. Experimental ileoileoanastomosis performed on dogs using handle interrupted mattress seromusculosubmucosal suture was healed with primary tension on 6 days after operation. In our opinion it became possible because of layer-to-layer matching of the ileum edges and single row type of developed suture.

On experimental biological model we studied the biochemical changes occurring in rabbits under various methods of simulating orthodontic treatment of dentoalveolar abnormalities. It was revealed, that stress-related changes in the alveolar process of animals are less pronounced following physico-pharmacological preparation than following surgical preparation. The use of magnetotherapy eliminates the negative impact of orthodontic treatment on the metabolic status of animals.

Introduction. Due to reactive postoperative process in the soft tissues of the cheek during extranasal procedures, as well as possible direct intraoperative damage to nerve endings (both sensory and motor), changes in neuromuscular conduction can sometimes be observed. To diagnose this phenomenon, it seems reasonable to use classical electrodiagnostics and quantitatively measure the excitability of facial muscles.
Purpose: to evaluate changes in neuromuscular conduction in patients undergoing extranasal procedures on the maxillary sinuses, using an additional preoperative planning step – determination of the optimal approach using personalized 3D models.
Methods. During the scientific study, electrodiagnostics were performed on all 60 patients from both the control and study groups to assess neuromuscular conduction disturbances. To determine the dynamics of changes  in neuromuscular conduction, electrodiagnostics were measured at Erb᾽s motor points corresponding to the levator labii superioris, levator anguli oris, superior and inferior portions of the orbicularis oris, and the exit point  of the second branch of the facial nerve before surgery, then on the 10th and 30th days after surgery. To calculate statistically significant differences between groups, the change in rheobase value on day 10 from baseline and on day 30 from baseline was calculated. The following limits were chosen to assess current fluctuations: a change in value within 10 % of baseline, from 10 % to 20 %, and over 20 %.
Results. Based on measurements at all points on days 10 and 30 post-surgery, the rheobase change in the group of patients who underwent preoperative planning was statistically significantly less than in the control group, with the exception of the exit point of the second branch of the facial nerve on day 30. In this case, there were no statistically significant differences between the groups. These results indicate less tissue trauma and faster restoration of neuromuscular conduction during surgery with individualized determination of the optimal location of the trepanation defect.
Conclusion. Based on the presented calculations, it can be concluded, that in the study group of patients, who additionally underwent preoperative planning to determine the optimal location for the trephine access, the change in rheobase was statistically significantly smaller than in the control group, indicating less tissue trauma during surgery.

High-intensity laser therapy is a promising method for the conservative treatment of osteoarthritis of large joints, including knee osteoarthritis. The aim of this study was to evaluate the efficacy of high-intensity laser therapy in phototherapeutic windows for gonarthrosis. A group of 62 patients with a confirmed diagnosis of grades 1–3 gonarthrosis, treated at the Republican Center for Medical Rehabilitation and Balneotherapy, was studied. A total of 620 infrared and red laser treatments were performed using a variant technique. 310 treatments were administered to two clinically matched groups of 31 patients each. In the observation group, treatments were performed according to accepted guidelines, while in the clinical group, laser treatment was administered to the phototherapeutic window area. Results showed that laser treatment to the phototherapeutic window area was more effective in reducing pain, improving gait kinematics, and resulting in greater patient satisfaction.

One of the most important tasks of society is to preserve the health of children, on which the development and defense capability of the state in the future depends. The aim of the study was to assess the morphofunctional status of primary school children. In the course of the study, it was analyzed, taking into account the presence of scoliosis, as one of the pathologies affecting the ability for activities related to military duty: physical development, component composition of the body, functional indicators (vital capacity of the lungs, strength of the hand of the leading hand), indicators of functional state (blood pressure, heart rate, double product indicator, coefficient of blood circulation efficiency) and adaptive reserves (adaptive potential of the circulatory system) of the body. The results of the study revealed unfavorable features of the morphofunctional status of the examined children and determined the current directions of preventive and health-improving work aimed at its optimization.

The treatment of chronic hematogenous osteomyelitis must be comprehensive and tailored to the stage of the disease process. During the acute exacerbation phase, radical surgical debridement is performed to remove all non-viable tissue, sequestra, pus, and pathological granulation tissue. An active continuous-flow irrigation drainage system is established to ensure the constant removal of pus and the administration of antiseptics. Stable fixation of bone fragments is achieved using external fixation devices.

Pressing issue in modern angioneurology is an improving diagnostic and therapeutic measures aimed at increa sing the effectiveness of thrombolytic therapy for cerebral infarction. Modern scientific data indicate that determining indications and contraindications for TLT is a multi-stage process based on the fundamental principle of «time is brain health.» This review presents current recommendations and scientific data reflecting approaches to optimizing the diagnosis and treatment of conditions associated with adverse outcomes after thrombolysis. Particular attention is paid to risk stratification for hemorrhagic transformation of the infarct zone based on the results  of several laboratory parameters (platelet count, INR, fibrinogen, D-dimer, absolute neutrophil to lymphocyte  ratio, glycemia, creatinine) before the start of thrombolytic therapy (TLT). Examples of laboratory data are given, the specific dynamics of which can, with a high degree of probability, predict an unfavorable outcome after completion of TLT in the first 24 hours. The need for regular scientific research aimed at improving the diagnosis and treatment of pathological processes associated with adverse outcomes after TLT is demonstrated. The term «pre-thrombolytic preparation» is substantiated and proposed for widespread use to clearly define a set of diagnostic and therapeutic measures aimed not only at determining the indications and contraindications for the use of etiopathogenetically substantiated hardware and/or drug methods for the treatment of MI, but also for the development of new methods for early diagnosis and treatment before prescribing thrombolytic therapy, simultaneously with thrombolytic therapy and within 24 hours after completion of thrombolytic therapy.

DKAC is characterized by acute renal failure and acute fatty degeneration of the liver resulting from severe, acute ketoacidosis (1,000 mmol/day versus a normal level of 100 µmol/L) occurring against a background of dehydration, insulin deficiency, and marked hyperglycemia.

Galactosemia is a rare hereditary disorder in which the onset and severity of the first clinical signs can vary significantly, from the first days of life to several months. The pathogenesis of galactosemia is based on a deficiency of the enzyme involved in the conversion of galactose to glucose. The accumulation of galactose and its toxic metabolites leads to the development of the corresponding clinical symptom complex. Neonatal screening is currently performed in the Republic of Belarus to ensure early diagnosis of galactosemia and prevent life-threatening complications. However, the disease can progress rapidly, requiring a multidisciplinary approach to diagnosis and treatment. Physicians must remain vigilant while awaiting screening results. The primary treatment method is a completely galactose-free diet. With timely initiation of dietary therapy, the prognosis for life and health is favorable. The article presents modern literature data and provides a clinical observation of two cases of classical galactosemia type I associated with «severe» mutations of the GALT gene, such as deletion Q188R, K285N, which manifested and progressed, however, completely differently, which, of course, is of academic interest to a practicing physician. 

Suicide is a complex and multidimensional phenomenon that is vastly impacted by several factors and perspectives. It is linked to various mental health disorders, increasingly connected with depression, which is one of the most pervasive disorders among the individuals who lose their life by suicide. In fact, according to the World Health Organization (WHO), approximately 726,000 individuals fall under this category each year, highlighting the much-needed importance that should be provided to this matter. Each incident is a tragedy that leaves lasting effects on those left behind, making it a pressing global health issue that transcends socioeconomic boundaries. This crisis is particularly acute among individuals with mental health disorders, as evidenced by the alarming suicide rates in both South Korea and Sri Lanka. In response to this challenge, the governments have implemented new management strategies aimed at addressing the rise in suicides linked to mental health issues, with a primary focus on improving mental health care and support systems. This study aims to conduct a comparative analysis of the risk factors and management strategies employed in the above two countries. The final goal being able to provide an insight into the factors that contribute to these rates and steps of directions that can benefit the overall wellbeing of the population.

This review offers a contemporary analysis of the evolving landscape of pulmonary hypertension (PH) diagnosis and management. It synthesizes current evidence on disease mechanisms and therapeutic approaches, with particular emphasis on the pivotal changes introduced by the 2022 ESC/ERS guidelines. Central to this update is the revised hemodynamic definition of PH, now confirmed at a mean pulmonary arterial pressure >20 mm Hg at rest, and a stricter criterion for pulmonary arterial hypertension (PAH) requiring a pulmonary vascular resistance >2 Wood Units. The article navigates the refined diagnostic algorithm essential for accurately distinguishing between the five clinical PH groups. Furthermore, it elaborates on the modern, multi-parameter risk stratification strategy, a critical tool for prognostication and tailoring treatment intensity. The efficacy of established targeted drug classes–including endothelin receptor antagonists, phosphodiesterase-5 inhibitors, soluble guanylate cyclase stimulators, and prostacyclin pathway agents–is evaluated. The rationale for employing combination therapy and the indications for invasive procedures such as atrial septostomy and lung transplantation are also discussed. While a cure remains elusive, the systematic adoption of a personalized, risk-based treatment paradigm is demonstrated to markedly enhance functional capacity, quality of life, and long-term survival outcomes for patients.

Enteroviruses are well-known causes of a wide range of infectious diseases, ranging from mild illnesses such as typical exanthema to severe conditions such as serous meningitis. Given the continued relevance of the disease, the potential for severe progression, and the lack of specific prophylaxis, epidemiological vigilance is necessary for enteroviral and its various forms. This article examines the clinical presentation of the most common forms of enteroviral infection.

The treatment of urolithiasis is one of the main topics in modern urology. The improvement of medical tools and the widespread use of various high-tech methods for treating urolithiasis contribute to the active and effective fragmentation of stones,but often lead to the formation of multiple small fragments that can cause obstruction of the urinary tract. In this context, lithotripsy therapy becomes a priority. The authors of the article present their own results of complex litokinetic therapy, which made it possible to achieve independent discharge of urinary calculi in 81.3 % of cases, increase the effectiveness of expelling stones from the ureter, reduce the intensity of renal colic, reduce the amount of analgesics consumed and reduce the need for surgical procedures and operations.

The literature review on the treatment of urethral injuries is conducted. The clinical case of posterior urethral reconstruction is presented. The proprietary method for repairing a complete posterior urethral rupture is described.

We report a case of a 57-year-old male with postoperative anterior mediastinitis that developed after sternotomy and myocardial revascularization for ischemic heart disease with postinfarction cardiosclerosiss.
The patient was admitted to Сlinic № 10 two months after coronary artery bypass grafting. Previous interventions at the referring hospital included resternotomy, pericardial debridement, and Robicsek reosteosynthesis. Upon transfer, our first-stage management consisted of surgical debridement and vacuum-assisted closure (VAC) therapy alongside systemic antibiotic and symptomatic treatment. After сontrol of deep sternal wound infection and patient stabilization, a subtotal sternal resection with excision of the anterior segments of ribs 2–7 bilaterally and bipectoral thoracomyoplasty were performed. The developed marginal necrosis of the skin-subcutaneous flaps required staged necrectomies aided by adjuvant VAC therapy and platelet-rich plasma.
4.5 months later, the patient was readmitted for an anterior mediastinal abscess and purulent fistulas at the sternal manubrium. Treatment involved surgical debridement with negative pressure wound therapy. After four cycles of VAC-therapy with intermittent surgical debridement, the wound was successfully closed with secondary sutures using «Platelet Gel» plates. The postoperative course was uneventful, and the patient was discharged  in satisfactory condition.

Autoimmune encephalitis (AE) is a severe but potentially curable disease of the central nervous system. One of the main representatives of AE is anti-NMDA receptor AE (autoimmune encephalitis with antibodies to NMDAtype glutamate receptors). The disease is characterized by polymorphic symptoms (neuropsychiatric disorders, dyskinesia, autonomic dysfunction), rapid progression with the development of life-threatening conditions requiring treatment in the intensive care unit (ICU) and a multidisciplinary approach in a multidisciplinary hospital. 
This article presents the results of our own clinical observations of the diagnosis and treatment of patients with anti-NMDA receptor AE who were urgently hospitalized in the intensive care unit and the neurology department of a multidisciplinary medical institution (State Institution «432 Order of the Red Star main military Clinical Medical Center of the Armed Forces of the Republic of Belarus») with a discussion of diagnostic features, intensive care, and the most significant aspects of pathogenetic and symptomatic treatment.

Extracorporeal methods of detoxification have a well-established place in the treatment of many diseases. These methods are often used when traditional methods of reducing intoxication, autoimmune, or inflammatory processes become ineffective. 
The inclusion of high-volume plasmapheresis in the complex intensive care of diseases accompanied by AKI with myoglobinemia is a promising technology.

Scientific publications indicate significant cognitive impairment in individuals with eating disorders. However, their clinical manifestations, nature, and intensity remain unclear.
The aim of this study was to examine the frequency and structure of cognitive impairment in 58 female patients with eating disorders (average age 10–40 years) undergoing treatment in a psychiatric hospital.
The authors describe one clinical case of a patient with bulimia nervosa and cognitive impairment. This article also presents data from scientific studies on the presence of cognitive impairment in individuals with a wide range of eating disorders (anorexia nervosa, bulimia nervosa, and binge eating disorder).

The article provides the main historical milestones related to the formation of the hospital in 1936, its location during the Great Patriotic War, and the hospital᾽s management, medical staff, and support personnel from 1936 to 2006.