The main problem of open access adenomectomy is the occurrence of intra- and postoperative bleeding, the frequency of which varies from 0.2 % to 10 %, and the volume of blood loss can reach 2–2.5 liters, especially with large sizes of BPH (more than 80 cm3). The frequency of blood transfusions in open enucleation of the prostate gland is 7–14 %. The occurrence of bleeding during surgery and after removal of adenomatous nodes slows down the tissue healing processes in the postoperative period, often requires transfusion of red blood cells and fresh frozen plasma, contributes to decompensation  of the patients‘ concomitant pathology, which increases the duration of inpatient treatment.

Maxillary sinusitis is one of the most common diseases in the clinical practice of a maxillofacial surgeon and an otorhinolaryngologist. Due to the fact that the majority of patients are young and middle-aged people, that is, the working-age population, this creates a serious medical and economic problem. The etiology of maxillary sinusitis is rhinogenic; odontogenic; traumatic. An analysis of archival medical documents over the past 5 years shows that odontogenic maxillary sinusitis accounts for on average almost half of all maxillary sinusitis – 1365 (47 %) cases. one of the most common treatments in the department of maxillofacial surgery, ranking second with 334 (21 %) cases. The study is based on an analysis of 2908 archival medical records of patients diagnosed with maxillary sinusitis who were treated at the 11th City Clinical Hospital in Minsk for the period from 2019 to 2023. The main causes of odontogenic maxillary sinusitis were identified: violation of oroantral anastomosis, periodontitis, connection of the root and sinuses with the oral cavity, foreign body (tooth root, implant, fragment of bone material, filling material). It was also revealed that the most common causes of maxillary sinusitis were: the first molar (36 %), the second molar (23 %), the third molar (16 %) and the second premolar (8 %).

Maxillary sinus (MS) cysts are benign formations that are often an accidental finding during X-ray examinations. The most informative methods are CT and MRI. Cysts usually look like round or domeshaped formations, most often localized in the lower part of the MS. Medical records of 86 patients  (51 men and 35 women) with MS cysts were analyzed; the age of the patients ranged from 18 to 83 years. It was found that in the presence of an MS cyst, only 66.3 % of patients had rhinological complaints (the most common complaint was nasal breathing difficulty- 54.6 %), in 33.7 % of patients, MS cysts were an accidental finding. Most often, MS cysts were located on the lower wall of the  MS (74 %), had an average volume of 2.1 cm3 and occupied less than half of the sinus volume in 74 % of cases. Sinusitis (53.5 %) and deviated nasal septum (66.3 %) may play a certain role in the development of maxillary sinus cysts. More than half of the patients (53.5 %), along with the cyst, had signs of hyperplasia of the mucous membrane on other walls of the maxillary sinus (according to CT data). No reliable connection between the presence of maxillary sinus cysts and allergies has been established.

The purpose of the study was to assess the dynamics of the nutritional status of cadets of the educational unit, for which indicators of body structure, the psychological and functional state of the body, its adaptive capabilities and physiological reserves at the beginning and end of training were studied. Based on the results of the study, it was concluded that the learning process in the educational unit contributes to the formation of optimal nutritional status in terms of the body fat component, Stange test, index of functional changes in the circulatory system and personal anxiety  in the majority of cadets, while the proportion of people with optimal indicators is relatively low nutrition according to the results of a comprehensive assessment is associated, in our opinion, with the low basic level of their physical fitness.

Hypoplasia – is the medical term for underdevelopment. Hypoplasia of the mandible (micrognathia) is associated with underdevelopment of the ramus or body of the mandible, in some cases both at the same time. The main causes of hypoplasia of the lower jaw in children are congenital and acquired. This pathological condition can be detected at the second stage of screening of pregnant women at 19–21 weeks of pregnancy. This pathology leads to both functional (breathing, chewing, swallowing, speech) and aesthetic disorders. Currently, various methods are known for eliminating underdevelopment of the lower jaw, such as the use of allo- and out-grafts or combined, the use of implants made of metals or polymer materials, compression-distraction osteosynthesis. Currently, in our country, as throughout the world, compression-distraction osteosynthesis (CDO) is actively used to eliminate hypoplasia of the lower jaw. Hypoplasia of the mandibular branch combines not only a shortened height, but also a change in the width of the branch.
The use of modern technical achievements (MSCT, OPTG, TRG, ultrasound, CDA, surgical guidance) allows not only to study in detail the deformation of the mandible, but also to supplement the necessary information for precise planning of surgical treatment and obtaining a predictable result. The main principles of surgical treatment of patients with an underdeveloped branch of the mandible are: 1) preoperative planning (production of a stereolithographic model of the skull, for spatial visualization of skeletal asymmetry, and a surgical template necessary for osteotomy and CDA fixation), 2) ultrasound and X-ray control at the distraction stage to determine the correctness of the vector of growth and dynamics of the formation of the jaw callus.

The purpose of this study is to characterize the genetic engineering biological therapy performed in children with juvenile idiopathic arthritis in the Republic of Belarus for the period 2020–2023. To achieve this goal, the prevalence of juvenile idiopathic arthritis among the child population  in the Republic of Belarus, the dynamics of the number and number of children being monitored for juvenile idiopathic arthritis, and the demographic characteristics of patients receiving or having received biological therapy were studied. The structure and frequency of prescribing biological therapy for patients with juvenile idiopathic arthritis depending on the region of residence was determined. Indications for biological therapy were clarified and analyzed.
As a result of the study, it was established that the prevalence of juvenile idiopathic arthritis in the republic is 45.0–46.9 per 100,000 children. There has been a steady annual increase in the frequency of use of biological therapy in the treatment of juvenile idiopathic arthritis. The leading reason for prescribing biological therapy to children (82.5 %) was the ineffectiveness of the previous use of the basic anti-inflammatory drug – Methotrexate, both in the form of monotherapy and in combination with glucocorticoids. The leading biological drug in the treatment of patients with the articular form of the disease was adalimumab. It was used in 87.4 % of patients with affected joints. In the treatment of the systemic form of the disease, tocilizumab was most often used (93.3 %). 
Considering the long period from the development of the disease to the prescription of biological therapy (up to 5–7 years), the development of side effects from the use of methotrexate and glucocorticoids (hormone dependence/hormone resistance, osteoporosis), earlier prescription of genetic engineering biological therapy in childhood is required.

Currently, inflammatory bowel diseases (IBD), in particular ulcerative colitis (ulcerative colitis), are an extremely urgent problem. The incidence of ulcerative colitis worldwide is increasing every year, and mainly among the working-age population, which makes inflammatory bowel disease a socially significant disease. The clinical picture of IBD is diverse, which often makes it difficult to diagnose and prescribe adequate therapy in a timely manner and inevitably negatively affects the prognosis of the disease. Endoscopic helps in the diagnosis of inflammatory bowel diseases (IBD).

Currently, due to the problems identified during a special military operation, the section of tactical medicine is given special attention. One of the problems we raised is directly related to pain relief.

Purpose of the study: to identify the main problems of self-help and mutual assistance related  to pain relief and the use of narcotic substances, as well as issues that arise with the close convergence of Russian and Belarusian legislation related to the use of the above-mentioned narcotic painkillers for the purpose of providing first aid, taking into account the characteristics of the damaging factor, as well as wound localization to optimize approaches to training personnel in tactical medicine units.
Materials and methods: analysis of data from patients in the intensive care unit of the Military Medical Academy of St. Petersburg, analysis of the causes of death of SVO participants from open data and the media, as well as analysis of sources publishing the distribution of causes of death of military personnel – participants in modern military operations.
Results and discussion
Basic first aid skills include a list and content of knowledge, the possession of which is a mandatory minimum for survival. The list of injuries received while participating in hostilities has undergone a number of changes due to changes in the conduct of hostilities and the types of weapons used. However, resolving issues that allow one to survive while providing self-help and mutual assistance remains in the same plane. First of all, these are issues related to pain relief and the use of narcotic drugs.  In our opinion, given the convergence of Russian and Belarusian legislation, a number of amendments should be made to the articles relating to the production and use of drugs for medical purposes in both one and the other legislation. 

Conclusions
The basic scope of first aid, including measures related to self-help and mutual assistance associated with pain relief with the help of narcotic substances, should be individualized depending on the mechanism and location of the injury, which is subject to correction in the legislative framework of both states.

The purpose of the study is to analyze the literature data on the use of negative pressure wound therapy in clinical practice, in particular in traumatology and orthopedics, to study the effectiveness  of the technique in a specific clinical situation, to assess its feasibility, as well as to summarize  the clinical experience of authors. 
Despite the universality of the method, in each specific clinical situation there are some subtleties in the use of negative pressure therapy systems. On the other hand, despite the seemingly indisputable absolute positive effect of negative pressure therapy, in some clinical situations its effectiveness is comparable to classical treatment methods, and due to some features, its use in such clinical cases becomes not economically justified. Negative pressure therapy is widely used both in the treatment of damage to integumentary tissues, wounds requiring skin-plastic treatment methods, and as part of the complex treatment of deep periprosthetic joint infection, chronic osteomyelitis, and open fractures of the extremities. Currently, negative pressure therapy is often used in surgical practice in the area of a postoperative wound in order to prevent infectious complications in individuals at risk. The use of negative pressure therapy has also found its place in the therapy measures of decubitation of various localizations.

Sepsis is one of the most important causes of death in developed countries, where almost 2/3  of the population is obese. Thus, the coexistence of both conditions is becoming a common occurrence in clinical practice, and an increasing number of scientific studies are aimed at studying the potential impact of obesity on sepsis, but their results remain controversial [1].
Compulsive overeating (CED), according to numerous studies, is one of the causes of obesity  in 40 to 70 % of cases, being a trigger factor for this disease. In this regard, there is an increasing need to study obesity in the context of compulsive overeating in critical conditions [2].
The aim of the work: to analyze the data of literary sources touching upon the issues of the influence of obesity (and along with it compulsive overeating) on   sepsis; to emphasize the advantages of a multidisciplinary approach in accompanying people with critical conditions with an assessment of eating disorders, in particular, a history of compulsive overeating.

The article presents modern concepts of chronic cholecystitis – concept and definitions, epidemiology, classification, main mechanisms of disease development, diagnosis and treatment.
Chronic cholecystitis is a chronic disease caused by ongoing inflammation of the gallbladder, leading to mechanical or physiological dysfunction of its emptying. There are two forms of chronic cholecystitis – calculous (occurring against the background of cholelithiasis) and acalculous (without gallstones).

Justification. To date, peritonitis remains one of the most difficult problems of abdominal surgery. The causes of peritonitis can be various diseases and factors, including gunshot wounds to the abdomen. Gunshot wounds of the abdomen occur in 4.7–16.2 %, while it is noted that with the development  of such peritonitis, there is a rapid development of multiple organ failure. It is known that the hormonal background of men and women is different, as a result of which there is a different reaction to stress, which undoubtedly affects the course of the postoperative period. At the same time, issues related  to the peculiarities of the course of the immediate postoperative period in case of gunshot wounds  of the abdomen, related to sexual differences, are not sanctified in the literature.
Goal. To study the features of the course of peritonitis caused by gunshot wounds of the abdomen in the civilian population, taking into account gender differences. 
Materials and methods. The basis for the study was the medical institutions of a surgical profile, the Chechen Republic, Lugansk and Donetsk People‘s Republics, in which surgical care was provided to the civilian population during the period of hostilities. Medical records were used as primary documentation. The study is multicenter, retrospective. 76 patients from among the civilian population who were treated for peritonitis caused by gunshot wounds to the abdomen were involved in the work. There were 35 (46.0 %) female patients and 41 (53.9 %) male patients. The inclusion criteria were: the presence of a gunshot (bullet or fragmentation) penetrating wound localized in the mesagastric region, aged 18 to 59 years, having signs of peritonitis upon admission. Exclusion criteria: non-penetrating nature of the wound, abdominal injury caused by injuries other than gunshot, the presence of injuries to the head, chest, limbs., persons younger than 18 years and older than 59 years.
Results. Based on the results obtained, it was found that peritonitis caused by gunshot wounds  to the abdomen is accompanied by a fairly high percentage of complications and death. The main causes of death are purulent-septic complications, which is confirmed by the data reflected in the literature. At the same time, our studies have shown that complications in such peritonitis depend on gender, so, in the group of men, the number of complications and deaths was higher than in the group of women. All these issues require further investigation.
Conclusion. Peritonitis, which develops as a result of gunshot wounds to the abdomen, is characterized by a high percentage of complications and deaths, respectively, 27,6 % and 36,8 % of cases.  At the same time, the development of complications of fatal outcomes depends on gender. So, in the group of men, complications occur in 25,0 %, and mortality is 26,3 %. In the group of women, complications occurred in 2,6 % of cases, and mortality was 10,5 %.

Aggressive angiomyxoma is a rare myxoid-mesenchymal neoplasm, mainly occurring in the pelvis and perineum in women, most often in the reproductive age group. In men, the tumor affects similar areas, including the scrotum and inguinal region, and usually appears at an older age. The main features of angiomyxoma are asymptomatic course and difficulties in diagnosis in the presence  of a tendency to deep invasion and recurrence after surgical treatment. A rare clinical case of pelvic angiomyxoma in a 64-year-old patient was described. The diagnosis was established after its removal. Literature on diagnosis and treatment of angiomyxomas is presented.

Pulmonary hypertension can develop in patients with bronchopulmonary pathology, as well as due to left ventricular heart failure. The difficulty of differential diagnosis between chronic respiratory and heart failure is due to the close pathophysiological connection between the respiratory and cardiovascular systems, as well as the similarity of clinical manifestations. The leading symptoms are progressive shortness of breath, fatigue on exercise, tachypnea, tachycardia, and peripheral edema syndrome. Differential diagnosis is based on a comparative analysis of the severity of organ damage and the degree of their functional impairment.

The main cause of jaundice with a predominance of direct hyperbilirubinemia in infancy is neonatal hepatitis, which resulted in atresia of the extrahepatic or intrahepatic biliary tract. However, the hereditary nature of the disease cannot be ruled out. A diagnostic search for the genesis of the disease and establishing the level of damage to the biliary system is a very complex task and requires non-routine laboratory and instrumental studies, such as ultrasound of the abdominal organs with duplex scanning and spectral Dopplerography, magnetic resonance imaging (MRI), liver elastography, percutaneous liver puncture biopsy. Consultations with a geneticist, hepatologist, and surgeon are necessary. Treatment of such a severe pathology that manifests itself in the neonatal period must be comprehensive and carried out on the principle of an interdisciplinary approach, carried out in highly specialized medical institutions. Diagnosis of hereditary diseases accompanied by cholestasis syndrome is not a routine research method, requires certain material costs, and is not always feasible in the Republic of Belarus. The authors of the article reviewed a clinical case of cholestatic jaundice identified in a boy in the second month of life. Dynamic observation of the child allowed us to assume the hereditary nature of cholestasis, which was the basis for further examination of the baby using the method of massively parallel sequencing (cholestasis panel) in the selective screening laboratory. Alagille syndrome type 1 was identified. The authors analyzed the directions of clinical, laboratory and instrumental search for disorders of the hepatobiliary system, and provided a detailed description of the present case, which, of course, is of academic interest for a practicing physician.

Guillain-Barré syndrome (GBS) is the most frequent form of acute inflammatory demyelinating polyneuropathy characterized by progressive disorders of the peripheral nervous system with the development of acute peripheral paralysis, bulbar, respiratory disorders, requiring in case of severe progressive course full-scale resuscitative measures, including mechanical ventilation. In order to raise awareness of general practitioners and specialists about SGB, we present our own clinical observation of care provided to military man D., 38 years old, regarding SGB with ascending Landry‘s palsy, bulbar and respiratory disorders.

Compulsive overeating disorder (COD, overeating associated with other psychological causes) is one of the most common eating disorders and is associated with significant concomitant somatic diseases, such as obesity, type 2 diabetes mellitus, heart failure, coronary heart disease, etc. According to numerous studies, COD can occur as a comorbid nosology in mental disorders: affective and anxiety disorders, substance abuse, post-traumatic stress disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, schizophrenia spectrum disorders, etc. [1]. Thus, the coexistence of compulsive overeating and other mental disorders is a common fact in medical practice, but the results of scientific research remain rather uninformative and contradictory [1].
The aim of the work: to analyze some data from literary sources on the issue of comorbidity of compulsive overeating and other mental disorders with the analysis of a clinical case from practice.