Metabolic syndrome (MS) in young adults has emerged as an increasingly prevalent health challenge, with recent studies reporting a 4.8–7.0% occurrence among individuals aged 18–30 years, primarily associated with decreased HDL cholesterol levels. The progressive rise in obesity and related metabolic disorders underscores the importance of early identification of neuroendocrine and circadian disturbances contributing to MS pathogenesis. Melatonin, a key regulator of circadian homeostasis and a potent endogenous antioxidant, plays a crucial role in metabolic regulation, including glucose control, lipid balance, and anti-inflammatory defense. This study examines the features of daily melatonin secretion in young patients with MS, emphasizing its diagnostic and pathogenetic significance. A reduction in nocturnal melatonin release and flattening of its circadian rhythm were observed, correlating with increased insulin resistance, dyslipidemia, and endothelial dysfunction. Altered melatonin excretion patterns, assessed through urinary 6-sulfatoxymelatonin profiles, reflect an early manifestation of chronobiological imbalance or “chronodissonance.” The findings highlight that disruption of melatonin rhythm may serve as an early biomarker of metabolic and vascular risk, supporting the role of circadian regulation in preventive and therapeutic strategies for metabolic syndrome in young adults.

This article provides a comprehensive analysis of the pathophysiology, clinical manifestations, complications, diagnosis, treatment methods, and rehabilitation of injuries related to electric shock. According to scientific sources, electric shock can lead to both acute and chronic complications such as cardiac arrhythmias, respiratory center paralysis, rhabdomyolysis, thermal burns, and nervous system damage. Emergency medical care, long-term monitoring, and individualized rehabilitation processes play a crucial role in restoring the patient’s quality of life. In global practice, preventing electrical injuries and developing modern diagnostic and treatment protocols remain pressing issues. The article offers scientific and practical guidelines, standards, and preventive approaches that can be applied in clinical practice.

Attachment styles adjust responses to stressful events via internal working models. Management of chronic diseases can be taxing enough to trigger attachment behavior. The aim of this study was to investigate the association between attachment styles and medication adherence across time. Attachment style was measured using the Relationship Questionnaire whereas medication adherence was measured using the Morisky Medication Adherence Scale-8. Data were obtained from 80 patients living with hypertension obtained through convenience sampling and the study used a quasi-experimental design. Dialectical Behavior Therapy was given to the experimental group while the control group continued with treatment as usual. The study findings revealed that at baseline medication adherence was lowest among participants with preoccupied (96.7% low, 3.3% moderate), followed by fearful (93.8% low, 6.2% moderate), and dismissing attachment style (91.2% low, 8.8% moderate). A non-significant association was reported (p = .838, Cramer’s V = .101). At endline medication adherence was highest among participants with earned secure attachment (5.3% low, 73.7% moderate, 21.1% high) followed by dismissing (48.3% low, 44.3% moderate, 6.9 high), preoccupied (58.8% low, 35.3% moderate, 5.9% high), and finally fearful attachment style (90.0% low, 10.0% moderate). Association between attachment styles and medication adherence was statistically significant (p < .001, V = .39) with moderate strength. Inferential analysis revealed that the intervention group across time demonstrated higher odds of medication adherence (OR = .11, p <.001) compared to the control, with consistent improvements from baseline to endline. The results indicate that internalized relational models influence patient commitment with treatment regimen and may sabotage satisfaction of psychological needs crucial for motivated health behavior. Incorporation of attachment-informed care into the management of hypertension would boost medication adherence. Adoption of longitudinal study designs in future research would help to investigate how durable earned secure attachment style is over time and its influence on adherence trajectories.

Oral Squamous Cell Carcinoma (OSCC) is the most common type of head and neck cancer, with the highest mortality rate. Traditional causes include smoking, alcohol consumption, tobacco use and betel chewing, while human papillomavirus (HPV) has recently emerged as an additional significant cause. Current challenges include a rising incidence in younger patients, variations in tumor location and biology, and early lesions that often resemble benign conditions, making timely diagnosis difficult.

HPV-positive OSCC shows a better prognosis and treatment response due to the radiosensitivity of HPV-associated tumors. Researchers have developed an HPV-positive OSCC model to study the biological mechanisms of HPV-induced disease and to identify optimal treatment intensity with low toxicity and high efficiency. Furthermore, advances in medicine, such as the use of salivary biomarkers and artificial intelligence, promise to enhance diagnosis in the future.

In addition to treatment, the issues of post-treatment life of patients need to be considered because patients often face mental and physical side effects for a long time after treatment. This review summarizes the current understanding of the role of HPV in OSCC and examines factors such as age, gender, delayed diagnosis, emerging diagnostic methods, and the influence of post-treatment quality of life on OSCC overall.

Background: Echinococcosis, a severe zoonotic helminthiasis, remains a significant medical and veterinary problem in many regions of the world, including Uzbekistan. The Andijan Region, characterized by intensive agriculture and livestock farming, presents a persistent focus of this disease. This study aims to analyze the long-term epidemiological trends and socio-economic impact of echinococcosis in the Andijan Region over a 25-year period (2000-2024).

Materials and Methods: A retrospective epidemiological analysis was conducted based on official statistical data from the Andijan Regional Sanitary and Epidemiological Station and the Ministry of Health. Data on incidence rates (per 100,000 population), patient demographics, localization of cysts, and sources of registration were analyzed. Socio-economic analysis was based on estimates of direct medical costs and indirect losses due to disability.

Results: The analysis revealed a fluctuating but persistently high incidence of echinococcosis in the region. The average annual incidence for the period was 3.8 per 100,000, significantly exceeding the national average for Uzbekistan. Two peaks of elevated incidence were identified: 2005-2008 and 2018-2021. A trend of "aging" of the disease was noted, with an increasing proportion of cases in the adult working-age population (30-60 years). The hepatic form accounted for 65-70% of cases, followed by pulmonary (20-25%) and other localizations. Rural areas demonstrated a 2.5-3 times higher incidence compared to urban centers. The socio-economic burden is substantial, with the average cost of surgical treatment and rehabilitation per patient estimated at $1,500-$2,000, leading to significant long-term disability.

Conclusion: Despite ongoing control measures, echinococcosis remains a serious public health challenge in the Andijan Region. The established long-term dynamics indicate the stability of the natural foci and the insufficiency of current interventions. An effective reduction in the disease burden requires a strengthened One Health approach, integrating enhanced veterinary control of dogs and livestock, active case detection in high-risk groups, and comprehensive public health education.

Atherothrombotic lesions of the extracranial arteries represent one of the main causes of ischemic stroke and are strongly associated with systemic inflammation and dyslipidemia. This study aimed to analyze the pathogenetic interrelations between inflammatory and lipid markers in patients with varying degrees of atherothrombotic extracranial artery stenosis. A total of 128 elderly patients (mean age 67 ± 7.2 years) diagnosed with internal carotid artery (ICA) stenosis were examined between 2022 and 2024. Based on lesion type, patients were divided into three groups: unilateral ICA stenosis (Group I, n = 41), bilateral ICA stenosis (Group II, n = 58), and combined ICA + vertebral artery stenosis (Group III, n = 29), with an additional control group (n = 20).

Biochemical markers such as high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and lipid profile parameters (LDL, HDL, total cholesterol, triglycerides) were measured and statistically analyzed using IBM SPSS 25.0, MedCalc 20.0, and R 4.2.2. The mean hs-CRP and IL-6 values showed a significant progressive increase from Group I to III (p < 0.05), reflecting enhanced systemic inflammation with advancing stenosis. Total cholesterol and LDL levels also increased significantly, while HDL levels showed a nonsignificant downward trend.

These findings demonstrate that chronic inflammation and dyslipidemia act synergistically in promoting atherothrombotic progression and plaque instability. The most severe biochemical alterations were observed in patients with combined ICA and vertebral artery stenosis, indicating a more generalized and aggressive form of vascular pathology. Regular monitoring of inflammatory and lipid markers is recommended for early identification of high-risk patients, better prediction of stroke risk, and optimization of therapeutic strategies.

Background: Chronic Obstructive Pulmonary Disease (COPD) and Ischemic Heart Disease (IHD) are leading causes of global morbidity and mortality, frequently coexisting as comorbid conditions. Their interplay creates a complex pathophysiological state that exacerbates the clinical course and worsens prognosis. The simultaneous assessment of pulmonary function, systemic inflammation, and cardiac strain in this comorbid population remains a critical area of investigation.

Objective: To study the changes in external respiratory function, the levels of key inflammatory cytokines (IL-6, TNF-α), and brain natriuretic peptide (NT-proBNP) in patients with COPD, particularly when it occurs in comorbidity with IHD.

Materials and Methods: A single-center, cross-sectional study was conducted at the Clinics of Tashkent State Medical University. A total of 120 male participants aged 45-70 years were enrolled and divided into three groups: Group 1 (n=40) - patients with COPD alone; Group 2 (n=40) - patients with IHD alone (stable angina, FC II); Group 3 (n=40) - patients with comorbid COPD and IHD. A control group (n=30) of healthy, age-matched individuals was also included. All participants underwent spirometry with bronchodilator testing. Serum levels of IL-6, TNF-α, and NT-proBNP were measured using enzyme-linked immunosorbent assay (ELISA).

Results: Patients with comorbid COPD and IHD (Group 3) demonstrated the most pronounced impairments in spirometric parameters (FEV1: 48.2±5.1% pred., FVC: 72.5±6.8% pred., FEV1/FVC: 52.8±4.9%) compared to other groups (p<0.001). These patients also exhibited a significant synergistic increase in inflammatory markers (IL-6: 8.45±1.32 pg/mL; TNF-α: 12.89±2.11 pg/mL) and NT-proBNP levels (485.6±75.4 pg/mL), which were substantially higher than in the groups with isolated diseases (p<0.001). Strong negative correlations were found between FEV1 and IL-6 (r = -0.78, p<0.01), FEV1 and NT-proBNP (r = -0.71, p<0.01), and a strong positive correlation between IL-6 and NT-proBNP (r = 0.82, p<0.01) in the comorbid group.

Conclusion: The comorbidity of COPD and IHD leads to a significant mutual aggravation of both conditions, characterized by severe obstructive ventilatory disorders, heightened systemic inflammation, and increased cardiac strain. The strong intercorrelations between these parameters suggest a shared pathophysiological pathway and highlight the need for an integrated diagnostic and therapeutic approach targeting both pulmonary and cardiovascular systems in this high-risk patient population.

The scoping review examines long-term side effects in patients who recover from life-threatening diseases while undergoing rehabilitation using qualitative research coupled with articles obtained exclusively from Google Scholar. The improved survival rates of critical illnesses from medical progress now require society to analyze the prolonged health effects patients face within and outside rehabilitation programs. The review details repeated physical along with psychological and social and occupational hurdles which survivors experience including persistent fatigue along with pain and anxiety and depression and social distancing and employment readjustment issues. The study looks into current rehabilitation approaches and establishes how multidisciplinary care helps address persistent consequences. The research data demonstrates that healthcare treatment lacks compatibility with complete rehabilitation therapies which address the individual as a whole beyond the acute phase. The study demonstrates the necessity to create comprehensive rehabilitation programs which focus on the individual patient and provide both physical and psychosocial support. The research is limited by database constraints along with its qualitative nature and requires future investigation to use expanded research methods and study diseases specifically. This review expands the field of knowledge that seeks to enhance both rehabilitation outcomes and survivor quality of life for persons facing life-threatening illnesses.

Background:

Postoperative nausea and vomiting (PONV) remains one of the most common complications after general anesthesia, particularly among morbidly obese patients undergoing bariatric surgery (1,2). Despite major progress in anesthetic management, the development of effective prophylactic regimens for this high-risk population remains an ongoing challenge (3,4).

Objective:

To evaluate the clinical efficacy of a rational three-agent prophylactic regimen consisting of dexamethasone, ondansetron, and droperidol in preventing PONV among morbidly obese patients after laparoscopic bariatric surgery.

Methods:

A prospective, single-center clinical study was conducted from May 2024 to March 2025 at Tashkent State Medical University. A total of 120 patients (75 women, 45 men; mean BMI 45.1 ± 6.3 kg/m²) undergoing laparoscopic bariatric surgery were included. All patients received standardized anesthesia. Participants were divided into three groups: triple prophylaxis (dexamethasone 8 mg, ondansetron 4 mg, droperidol 1.25 mg), dual prophylaxis (dexamethasone + ondansetron), and no prophylaxis (TIVA). The incidence and intensity of PONV were recorded for 24 hours.

Results:

The overall PONV incidence was 26%. Women had significantly higher rates (32%) compared to men (15%, p < 0.05). The triple prophylaxis group showed a PONV rate of 14.2%, while the dual and control groups demonstrated 42.6% and 38%, respectively (p = 0.002). The requirement for rescue antiemetics was lowest in the triple-therapy group (18%) (7,8).

Conclusion:

A rational three-agent regimen (dexamethasone, ondansetron, droperidol) significantly reduces the incidence and severity of PONV in morbidly obese patients after laparoscopic bariatric surgery. Continued research should aim to refine dosing and timing strategies to enhance clinical outcomes.

Background: The intricate three-dimensional nature of facial muscle anatomy presents a significant learning challenge for medical students. While traditional teaching methods like cadaveric dissection and didactic lectures have their merits, there is a growing need for innovative, engaging, and student-centered pedagogical approaches that can enhance spatial understanding and knowledge retention. This study aimed to evaluate the effectiveness of a hands-on clay modeling workshop as a supplementary tool for teaching facial muscle anatomy to medical students.

Methods: A mixed-methods study with a pre-test/post-test control group design was conducted with second-year medical students. Participants were randomly assigned to either an intervention group (n=50), which attended a clay modeling workshop, or a control group (n=50), which received a standard lecture. Anatomical knowledge was assessed using a pre-test and post-test. Qualitative data on student perceptions were collected through focus group interviews and surveys and analyzed using thematic analysis.

Results: The intervention group demonstrated a significantly greater improvement in post-test scores compared to the control group (p < 0.001). Thematic analysis of the qualitative data revealed three key themes: (1) enhanced spatial understanding, (2) increased engagement and enjoyment, and (3) the value of peer learning and collaboration. Students in the intervention group reported that the tactile and creative nature of the workshop made learning facial anatomy more intuitive and memorable.

Conclusion: The findings suggest that clay modeling is an effective and well-received pedagogical tool that can significantly improve medical students' understanding of complex facial muscle anatomy. Integrating such hands-on, creative learning modalities into anatomy curricula can foster a more engaging and effective learning environment, ultimately leading to better-prepared medical professionals.