The review is devoted to the history of the fight against leprosy in the Republic of Karakalpakstan, as well as the role of leading Russian doctors and scientists, leprologists, epidemiologists in reducing the incidence of leprosy in the region. Epidemiological data and dynamics of the spread of leprosy in the republic are presented. The problems and main issues of further development of the anti-leprosy service are identified.

The results of operations in 18 patients with incisional hernias that occurred after obstructive colon resections due to complications of cancer and benign diseases were analyzed. The hernias were eliminated simultaneously with the restoration of the continuity of the colon. 9 patients with large hernias underwent operations with separation of abdominal wall components (component separation). Despite the increase in the duration of operations, their simultaneous execution was not accompanied by significant complications.

Objective: to create prognostic tables for delayed physical development of children who have experienced drug intoxication in the prenatal period. Materials and methods. The research materials are presented by the study group (51 children) and the verification group of children (10 people). The study group consisted of children aged 1 to 14 years who had prenatal exposure to opiates. Research methods included medical history, follow-up observation and statistical processing of the data obtained using the “Statistica 9.0” program. Results. A prognostic algorithm has been created in tabular expression of the most informationally significant 19 risk factors that have both a prognostically significant and leveling effect on the formation of future delays in the child’s physical development. prognostic table of risk data for the development of delayed physical development in children born to drug-addicted women. The obtained data was verified by a verification group. The effectiveness was 90 % (9 prognostic scenarios adequately reflected upcoming events. Conclusion. The developed predictive algorithms for delayed physical development in children who were exposed to opiates in the prenatal period are applicable in the practice of a pediatrician and create a real opportunity to draw up individual scenarios. The data obtained will help to prevent the development of pathology in a timely manner.

This article examines the clinical picture, diagnosis and treatment of a 36-year-old patient with symptoms of columbian hypertension syndrome due to omission of the tonsils of the cerebellum. Arnold – Chiari malformation is a rare congenital disease characterized by displacement of the brain and its structures into the cervical canal area due to the development of the posterior skull. In the practice of neurologists and neurosurgeons, each clinical case of Arnold – Chiari malformation is a difficult task for the diagnosis, treatment and relief of the patient's symptoms. Goal. Description of a clinical case in a patient with Arnold – Chiari malformation to study the features of diagnosis, treatment and intervention results in the practice of neurologists and neurosurgeons. Materials and methods. The article describes in detail the clinical case of a patient with Arnold – Chiari malformation, including anamnesis data, examination results, medical measures taken and treatment results. Results. The patient, who was experiencing severe neurological symptoms, including dizziness, nausea, speech and coordination disorders, received treatment with good results. After surgery, there was a regression of symptoms, restoration of cerebrospinal fluid outflow and clinical improvement of the condition. Conclusion. Surgical intervention by decompression and laminectomy has shown effectiveness in the treatment of columbian hypertension syndrome with omission of the cerebellar tonsils in this patient, which led to an improvement in her neurological status and a decrease in clinical manifestations. The study of the clinical case of a patient with Arnold – Chiari malformation demonstrates the importance of timely diagnosis, expert advice and the right choice of treatment strategy in the practice of neurologists and neurosurgeons to achieve successful results and improve the quality of life of patients.

The abuse of alcoholic beverages and the consequences of its impact on the internal organs and nervous system, remains an urgent medical and social problem for our country for a long time. Alcoholism has an extremely negative effect on the functioning of the cerebellar system, causing dynamic and static-locomotor ataxia and damage to the peripheral nervous system, which aggravates the impaired function of walking and coordination. Due to the concomitant emotional and cognitive disorders, age-related features in individuals suffering from alcoholism, the diagnosis of clinical manifestations of ataxia and comorbid cerebral, visceral pathology has a number of features that need to be considered for the diagnosis and treatment of the patient.

The search for dependencies of public health characteristics and economic indicators is practically an urgent task of public health. The purpose of the study is to analyze methodological approaches to the identification and measurement of economic determinants of public health. Materials and methods. The existing approaches to the identification and measurement of the economic determinants of public health are used as materials. In total, four approaches were studied: assessment of the level of disposable income per household member; assessment of the structure of expenses, in particular the proportion of expenses for the purchase of food; subjective assessment of housing conditions; subjective assessment of the financial situation. An analytical method was used in the research process. The analysis was carried out in terms of the complexity of using the approach and the results of its use in other public health studies. Conclusion. Four methodological approaches to the identification and measurement of economic determinants of public health have been identified. None of these approaches is optimal and devoid of methodological difficulties when using it. In any case, it is not possible to avoid subjectivity in the assessment. However, human behavior and his attitude to his health, in particular, is determined precisely by subjective perception, and not by clearly defined and verifiable objective economic characteristics. Therefore, the use of such information in the study of the influence of economic determinants on public health indicators is quite acceptable. The most appropriate approach seems to be to use several approaches with further comparative analysis of the results obtained.

Topicality. Macular hole is an acquired disease characterized by a through defect of retinal tissue in the macular zone, leading to decreased central vision, the occurrence of metamorphopsia and central scotoma. In recent years, in the treatment of this condition, techniques associated with closing the macular defect with autologous blood and its components have become increasingly interesting. In particular, the use of autologous conditioned plasma obtained by centrifugation in a patented double syringe. Purpose. Analysis of our own clinical results over five years of experience in using ACP in the treatment of macular holes of various diameters. Materials and methods. 102 patients (102 eyes), whose age ranged from 50 to 65 years, were under observation. Depending on the size of the hole, the patients were divided into three groups. The surgical tactics for treating macular holes consisted of vitrectomy using the standard 3-port 25 G. Autologous conditioned plasma (ACP) was obtained by collecting 20 ml of the patient's venous blood, followed by centrifugation for 5 minutes using a proprietary dual syringe (Arthrex ACP) and applying the contents to the area of the rupture. Patients were followed up for 6 months after surgery. Results. Complete closure of the macular hole with the formation of the foveal fossa was achieved in 94.2 % of cases. In 6 patients there was no complete approximation of the edges of the macular hole. These patients were taken for revision surgery using mechanical approximation of the edges of the macular hole. OCT follow-up after 6 months revealed no recurrence of macular tears in all patients. Conclusion. The possibility of local use of ACP plasma in vitreomacular interface surgery, in particular for macular holes, taking into account its regenerative and reparative properties, allows one to obtain a good anatomical and functional result with the achievement of high visual functions and minimize trauma to the retinal tissue during surgery.

The purpose of this study is to determine a rational and effective routing scheme for patients with congenital clefts of the upper lip, palate, and alveolar process of the upper jaw in the Astrakhan region. We have analyzed the provision of medical care to patients with congenital anomalies of the maxillofacial region on the basis of Aleksandro-Mariinskaya Regional Clinical Hospital, Children Regional Clinical Hospital named N. N. Silishcheva, private dental clinic “Clinic of Dr. Nesterov”, and the charitable foundation “Operation Smile”. The article examines the etiology of congenital facial abnormalities, the importance of functional and aesthetic disorders, the importance of providing comprehensive care, and suggests routing schemes for patients with this pathology, with the participation of specialized specialists, with an assessment of the results of conservative and surgical treatment.