Volume 8.
Issue 04.

The article presents data from the literature concerning current perspectives on the impact of fetal macrosomia on the development of obstetric and perinatal complications. Fetal macrosomia is one of the pressing issues in modern obstetric practice. In recent years, there has been a significant increase in the number of births of infants with high birth weight. This phenomenon has not only medical but also social significance, negatively affecting the health of both the mother and the child.

Oral cancer is a major health problem in the world, with significant morbidity and mortality rates that are mostly because they are not diagnosed early enough or because the lesions are often not detected at an early stage. Intraoral imaging has become a convenient and non-invasive screening tool, but diagnostic performance is highly reliant on clinician experience, and there is a wide range of heterogeneous imaging conditions across devices and clinical environments. This paper will attempt to overcome these shortcomings by introducing OralLesionNet, a dense multi-scale convolutional neural network (CNN) architecture that can effectively detect oral cancer using intraoral images with a higher degree of domain generalisation. The proposed model incorporates a dense multi-scale backbone to achieve fine-grained textural features, as well as coarse morphological features, to facilitate a better ability to differentiate benign and malignant lesions. The domain generalisation module is included in the training to promote the learning of invariant features to mitigate the performance decline due to inter-centre and device-related variations. The model was tested on a free, publicly available intraoral image dataset of benign and malignant cases that were clinically verified. To obtain a credible assessment, extensive preprocessing, augmentation, and train-validation-test splitting were used. The experimental outcomes indicate that OralLesionNet is more accurate, more precise, more recalls, more F1-score, and more area under the ROC curve (AUC) than baseline CNN, ResNet and DenseNet architectures. Ablation experiments validate the claims that multi-scale design and domain generalisation strategy play an important role in enhancing performance. The sensitivity obtained with the proposed framework is very high; this is very important in screening applications where false negatives should be reduced to a minimum. These results suggest that oral lesion classification can be made more robust and generalizable with dense multi-scale representation and domain-aware learning. OralLesionNet has a good potential of becoming a computer-aided diagnostic support tool that could enhance the ability to detect at earlier stages, minimise the inter-observer variability, and expand the screening to resource-limited settings.

Background: Anticoagulant therapy, while essential for thromboembolic disorders, carries risks of bleeding and mucosal injury. Chitosan, a natural polysaccharide, has demonstrated hemostatic, mucoadhesive, and wound healing properties. This article systematically analyzes clinical studies evaluating chitosan’s effectiveness as an adjunct during anticoagulant therapy (vitamin K antagonists, direct oral anticoagulants, heparins). Methods: A structured search of PubMed, Cochrane Library, Web of Science, and eLibrary (2000–2025) identified 24 clinical trials and observational studies. Primary outcomes included reduction in minor bleeding episodes, time to hemostasis after dental/surgical procedures, and patient reported mucosal comfort. Results: Meta-analysis of 11 randomized controlled trials (n=1,452 patients on anticoagulants) showed that chitosan-based dressings or oral formulations reduced post extraction bleeding time by 42% (95% CI: 35–49%, p<0.001) and decreased gingival bleeding index by 61% compared to controls. Seven studies on gastrointestinal bleeding risk reported a 53% relative risk reduction (RR 0.47, 95% CI 0.32–0.69). Conclusion: Chitosan is effective and safe as an adjunctive hemostatic agent in patients receiving anticoagulant therapy, particularly for mucosal bleeding. Further large-scale trials are warranted to standardize formulations and dosing.

This research work is dedicated to studying the histological layers of arterial vessels and their functional interrelationship with the microcirculatory track (MCT) system. The article analyzes the role of the endothelial layer, smooth muscle cells, and elastic elements within the arterial wall in maintaining hemodynamic stability. Specifically, the mechanisms by which arterioles, acting as "resistive vessels," regulate pressure transformation in microcirculation are histomorphologically substantiated. The findings serve as a theoretical foundation for understanding the morphogenesis of vascular pathologies.

This study investigated the effect of a diet enriched with the feed additive “ProBioKorm” on the digestion process in rabbits. During the experimental period, this probiotic additive was incorporated into the basal diet of rabbits, and its effects on nutrient digestibility, the functional activity of digestive organs, and the intestinal microflora were evaluated. The obtained results demonstrated that the use of a diet enriched with “ProBioKorm” activates digestive processes in rabbits and significantly increases the biological utilization of nutrients. In addition, normalization of the intestinal microflora, enhancement of enzymatic activity, and improvement of the overall physiological condition were observed. The results of the study indicate that the “ProBioKorm” additive can be effectively used as a dietary supplement in rabbit nutrition and justify its promising application in agricultural practice.

This article presents the results of studies examining changes in toxic hepatitis and proposes methods for correcting this pathology. Methods for correcting these disorders using antioxidants, membrane stabilizers, immunomodulators, coenzymes, and other biologically active substances are proposed. The article also presents the results of using these substances in experimental studies.

Acute cerebral circulatory accidents (stroke) represent a leading cause of mortality and long-term disability worldwide. Despite advances in acute management, neuroprotection and post-stroke rehabilitation remain challenging. Melatonin (MT), a neurohormone regulating circadian rhythms, has emerged as a promising neuroprotective agent due to its potent antioxidant, anti-inflammatory, and mitochondrial-protective properties. This review synthesizes current literature on the relationship between sleep disturbances, circadian disruption, and stroke outcomes, with a specific focus on melatonin’s therapeutic potential. We analyze data from clinical studies, quantitative electroencephalography (QEEG) findings, and epidemiological reports. Results indicate that melatonin levels decline with age, coinciding with increased stroke risk, and that exogenous melatonin administration during the acute phase of ischemic stroke may improve neurological recovery, reduce oxidative stress, and normalize sleep architecture. We present averaged-index tables and figures illustrating melatonin’s effects on EEG spectral power, infarct volume, and functional outcomes. This review concludes that melatonin is a safe, accessible adjunct therapy for acute ischemic stroke, though larger randomized controlled trials are needed.

In modern medicine, painkillers are widely used in the treatment of diseases and complications of some diseases. According to the World Health Organization, about 30 million people worldwide use painkillers per day. For example, in Malaysia, the consumption of NSAID is 14.2%, of which 4.2% is considered daily consumption. In Iran, it is 14.7% among 35-70-year-olds, and in Saudi Arabia this figure is 14.0%.

The aim of this study is to comprehensively evaluate the clinical and functional characteristics of long-term respiratory outcomes in children with neonatal respiratory distress syndrome (RDS) in the Uzbek healthcare system. The methodological framework includes a retrospective analysis of medical data, dynamic observation, and functional diagnostics of the respiratory system using spirometry, pulse oximetry, and assessment of bronchial reactivity.

Background: Severe traumatic brain injury (sTBI) is characterized by intense neuroinflammation and progressive cerebral edema, which significantly impact morbidity and mortality. Conventional anti-edema therapies often provide limited control over the inflammatory cascade. This study evaluates the clinical efficacy of augmenting standard treatment with Nimesulide, a non-steroidal anti-inflammatory drug (NSAID), to mitigate cerebral edema and improve neurological recovery.

Methods: A prospective clinical study was conducted on 150 patients with sTBI. Patients were divided into two groups: the Main Group (n=115), receiving standard intensive care supplemented with Nimesulide, and the Control Group (n=35), receiving standard therapy alone. Neurological status was assessed using the Glasgow Coma Scale (GCS) on days 1, 5, and 10. Secondary outcomes included the incidence of complications (pneumonia, seizures), laboratory markers of systemic inflammation (Neutrophil-to-Lymphocyte Ratio - NLR), and neuroimaging dynamics via MSCT and ophthalmoscopy.

Results: On day 1, GCS scores were comparable between groups (9.1±1.2; p>0.05). By day 10, the Main Group showed significantly higher neurological recovery (13.1±1.7) compared to the Control Group (11.5±1.6; p<0.05). NSAID-augmented therapy was associated with a lower incidence of pneumonia (19.1% vs 28.6%) and post-traumatic seizures (14.8% vs 25.7%; p<0.05). Laboratory findings revealed a more rapid normalization of NLR and endotoxicosis markers in the Main Group. MSCT and ophthalmoscopy confirmed accelerated regression of cerebral edema and earlier stabilization of the artery-to-vein ratio (1:1.5) in patients receiving supplemental anti-inflammatory therapy.

Conclusion: Augmenting standard sTBI protocols with Nimesulide significantly accelerates neurological recovery, reduces the volume of cerebral edema, and lowers the frequency of life-threatening complications. These findings suggest that targeting neuroinflammation is a crucial component in optimizing outcomes for patients with severe traumatic brain injury.

The chemical composition of the leaves of Pistacia vera has been studied for the first time. Plant material was successively extracted with chloroform and 70% acetone. The acetone extract was distilled off on a rotary evaporator to an aqueous residue. The aqueous portion was then fractionated with ethyl acetate. Individual compounds were separated by column chromatography and their chemical structure was established by physicochemical (UV, IR, NMR, mass spectroscopy) research methods.

Background: ongenital obstructive uropathies (OU) significantly contribute to neonatal morbidity. This study aims to evaluate an improved three-tier regional model of perinatal monitoring adapted for the Samarkand region.

Methods: A prospective study was conducted (2020–2026) involving the development of a "Prognostic Screening Sheet" based on maternal risk factors (OR analysis) and a standardized "72-hour rule" for postnatal ultrasound.

Results: The implementation of the model reduced the average age of surgical correction from 8.5 \pm 2.1 to 3.2 \pm 1.4 months. Early decompression in critical cases (e.g., posterior urethral valves) was shifted from day 25 to day 3 of life. Nephrectomy rates decreased by 18% , and hospitalizations for acute pyelonephritis in the first year dropped by 32%.

Conclusions: The transition to a "fetus as a patient" paradigm and the integration of obstetric and pediatric services ensure organ-preserving outcomes and prevent early-stage chronic kidney disease.

Diabetes mellitus (DM) is one of the foremost medical and social challenges of the 21st century, and diabetic neuropathy (DN) is one of its most common complications, occurring in 50–60% of patients with long-standing disease. The aim of this study is to systematize current data on the pathophysiological mechanisms of DN and to analyze the role of metabolic, vascular, oxidative, inflammatory, and trophic factors in nerve tissue damage. A systematic literature review (2014–2024) was conducted using international and Russian databases (PubMed, Scopus, Web of Science, RSCI, eLIBRARY.RU) with the following keywords: "diabetes mellitus," "diabetic neuropathy," "hyperglycemia," "polyol pathway," "advanced glycation end-products," "oxidative stress," "nerve growth factor," and their Russian equivalents. The pathogenesis of DN involves the activation of the polyol pathway, the accumulation of advanced glycation end products, mitochondrial and endothelial dysfunction, chronic inflammation, and a deficiency of neurotrophic factors, all of which lead to progressive nerve tissue damage. Understanding these mechanisms offers opportunities for early diagnosis, the development of biomarkers, and pathogenetically-based therapy. A comprehensive approach to treatment can slow the progression of this complication and improve patients' quality of life.

Cardiac surgery–associated acute kidney injury (CSA-AKI) in young children is a common and clinically significant complication following surgical correction of congenital heart defects, developing as a result of the combined impact of baseline renal vulnerability and intraoperative perfusion stress.

Objective. To identify clinical and pathophysiological risk factors for CSA-AKI and to determine independent predictors of its development in young children. The study included 585 children under 3 years of age who underwent cardiac surgery with cardiopulmonary bypass. CSA-AKI was diagnosed according to KDIGO criteria. Preoperative and intraoperative factors were analyzed using univariate and multivariate statistical methods. CSA-AKI developed in 224 patients (38.3%). At the preoperative stage, significant risk factors included heart failure, hypoxemia, low body weight, and high complexity of congenital heart defects. In the intraoperative period, the risk of CSA-AKI was significantly associated with cardiopulmonary bypass duration >90 minutes, hyperlactatemia, hematocrit <25%, and reduced urine output. Multivariate analysis identified elevated lactate levels, prolonged perfusion duration, hemodilution, and early renal functional response as independent predictors. CSA-AKI in young children is determined by a combination of preoperative and intraoperative factors reflecting impaired systemic perfusion and oxygen delivery. Early risk stratification and targeted control of modifiable perfusion parameters are essential for prevention.

At present, congenital deformities of the neck remain one of the actual problems in pediatric orthopedics. Indications for conservative or surgical treatment of these pathologies are determined based on the patient’s age, and staged rehabilitation is carried out after surgery. The study included 58 patients aged from 1 to 18 years who underwent treatment. In cases of congenital muscular torticollis, performing surgical treatment early, starting from the age of 1 year, allowed us to prevent further complications.ик.

Large language models (LLMs) are increasingly deployed in clinical documentation workflows to alleviate physician burnout and improve efficiency. As encounter transcripts often exceed 2,000-5,000 tokens, prompt compression techniques like LLMLingua have emerged, promising 50-80% token reduction to manage computational costs. However, these generic methods optimize for maximum compression without domain awareness, creating systematic risks in healthcare settings where information loss can directly impact patient safety. This paper presents a critical analysis establishing that clinical text possesses three properties that resist aggressive compression: (1) high information density (predominantly medically relevant content), (2) semantic fragility (single-token changes invert clinical meaning), and (3) liability context (documentation errors cascade to patient harm). We demonstrate through analysis and failure mode examination that generic compression creates dangerous error patterns-negation inversions ("denies chest pain" → "chest pain"), dosage omissions ("metformin 500mg" → "metformin"), and laterality loss ("left knee" → "knee")-that standard NLP metrics like ROUGE fail to detect. We propose the Clinical BERT Safety Gate, a safety-constrained framework with five architectural principles requiring conservative compression limited to demonstrably safe filler removal, domain-aware span protection, and clinical fidelity evaluation. This work challenges the field's efficiency-first paradigm and establishes compression safety as a first-class architectural requirement for clinical NLP systems. Our framework provides actionable guidance for researchers, practitioners, and healthcare AI vendors deploying LLMs in high-stakes clinical applications.

The article presents data from the literature concerning current perspectives on the impact of fetal macrosomia on the development of obstetric and perinatal complications. Fetal macrosomia is one of the pressing issues in modern obstetric practice. In recent years, there has been a significant increase in the number of births of infants with high birth weight. This phenomenon has not only medical but also social significance, negatively affecting the health of both the mother and the child.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders of childhood and is accompanied by significant changes in cognitive functioning, affecting the mechanisms of attention, executive control, working memory, and behavior regulation.

Objectives: To compare the efficacy of intervertebral fusionand removal of the nucleus pulposus in the treatment of herniated discs. Methodology: systematic review with meta-analysis in which the bibliographic search through the electronic databases: PubMed/MEDLINE and Cochrane Library without language restriction of publications untilApril 26, 2024. Results: The studies showed insignificant differences between the variations in the Oswestry disability indices of patients undergoing endoscopic microdiscectomy and open discectomy, a greater algic condition, greater bloodloss and length of hospital stay for the open discectomy procedure. Conclusion: Endoscopic microdiscectomy is related to better outcomes.

The aim of this work is to investigate the osmotic dilatation of human erythrocytes with various hypercholesterolemias. stress resistance It is the ability of the cell membrane to maintain its shape under various turgor conditions and to resist hemolysis. Cholesterol level increase erythrocyte membrane lipids the composition changes, that with together osmotic stability reduce possible.

This article systematizes the neurogenic and psychophysiological mechanisms of stress-induced cardiovascular diseases, including Takotsubo syndrome, as well as psychological risk factors and preventive directions. It shows that catecholamine release, inflammation, endothelial dysfunction, personality traits, and a lack of social support form a unified pathogenetic framework that should be addressed by psychocardiological and rehabilitation interventions.