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Background: Control of rifampicin-resistant tuberculosis (RR-MTB) requires novel technologies for restoring the anti-TB efficacy of priority drugs. We sought to evaluate the ability of nanotechnology application in the recovery of the anti-tuberculosis efficacy of rifampicin.

Methods: Nanocomposite- standard dose of rifampicin and 20 nm silver nanoparticles (AgNPs) suspension solution of 6 different concentrations: 0.25%; 0.5%; 1%; 2.5%; 5%; and 10%, were supplemented to 70 rifampicin-resistant mycobacterium tuberculosis (RR-MTB) isolates. The control arm consisted of 35 RR-MTB isolates and AgNPs suspension with identical concentrations. The inhibitory effect of nanocomposites was evaluated by MTB growth rate using the BACTECTM MGIT 960TM. The safety assessment of single-use AgNPs was conducted in experimental animals.

Results: The suppression process of AgNPs on RR-MTB isolates started with 2,5% nanocomposite solution application and full suppression was achieved in 5% and 10% nanocomposite solutions. A standard dose of rifampicin and a 2.5% solution of AgNPs increased the minimal inhibitory effect on RR-MTB by 10% (total 80%) vs the isolated use of a 2.5% solution of AgNPs (70%). An experiment on animals revealed the complete safety of a single injection of ultra-high doses of AgNPs.

Conclusion: The study showed the potentiating effect of AgNPs in overcoming the resistance of MTB to rifampicin providing a scientific basis for further research.

Physical and mental health play an important role in managing and characterizing a person's quality of life (QOL) and physical activity is proposed as one of the ways to improve QOL and well-being. This study aimed to quantify the effect of different fitness training programs and frequency on health-related quality of life (HRQOL). The percentage of participants with high levels of fitness is higher among men than women. There is an association between the level of PF activity and age. Аs expected, PF activity is lower in the elderly compared to the younger and middle-aged participants. From the HRQOL domains, low general health and mental health scores. High and medium-frequency training can presumably help improve the total quality of life scores, as well as scores for Physical and Mental components, significantly affecting domains PF, GH, VT, RE and MH. To improve the SF domain, high-frequency training is preferable. These results can become important for the implementation of programs aimed at improving the HRQOL of the population.

Aim: The aim of the article is to analyze the current state of functioning of the medical information space of Ukraine in order to formulate scientifically sound proposals aimed at improving the implementation of medical reform.

Materials and methods: The study is based on the analysis of literary sources of Ukrainian and international scientists, Ukrainian and foreign legislation and judicial practice. The article uses general theoretical and special methods of scientific cognition: theoretical analysis, systemic and structural, analysis and synthesis, sociological and statistical, logical and semantic, comparative and legal, method of ascent from the abstract to the concrete, forecasting and generalization.

Results: One of the key categories of the reform of the Ukrainian national medical sphere - the unified medical information space and its constituent elements - is studied. The electronic health care system, which stores medical data about patients in a single place and ensures their exchange between medical institutions, is analyzed. Emphasis is placed on the possibilities of using telemedicine and artificial intelligence, which play a key role in the development of the unified medical information space in accordance with global trends. The importance of legislative provision of efficiency and safety of the unified medical space is emphasized. It is about regulating the protection of personal data, establishing technical standards and requirements for medical information systems, ensuring confidentiality, integrity and data availability of the unified medical information space.

Conclusions: Conclusions are drawn about the importance of proper functioning of each of the elements of the unified medical information space, both individually and in conjunction with each other. The authors' vision of improving the existing system of the unified medical information space is presented.

Introduction: Despite being highly preventable, cervical cancer (CC) is the eighth most prevalent form of female cancer in Armenia and the second most common malignancy among those aged 15 to 44. In Armenia, there is an age-standardized incidence of 7.8 per 100,000 females, and an age-standardized mortality of 4.6 per 100,000 females. Globally, the CC is the 4th most common cancer among women. Its incidence was 604,127 new cases and 341,831 deaths in 2020. We conducted a retrospective, observational cohort study using clinical data to verify the influence of HPV vaccine (Gardasil, Merck&CO) on fertility function in women, vaccinated in RA since 2017 year in the limits of anti-HPV vaccination Program (included in National Vaccination Calendar).

Materials and methods: For the study, we analyzed data received from Armenian-American Wellness Center (Yerevan, Armenia). 98 female volunteers vaccinated with the 4vHPV who attended AAWC and were examined for reproductive function. The subjects were divided into 3 age groups - 1st group - 15 years -24 years 11 months, 2nd group - 25 years -34 years 11 months, 3rd group - 35 -40 years. Each control group was composed of randomly selected 30 healthy women in age identical to the main group who applied AAWC for regular checkup in the same time frame and have never been exposed to anti HPV vaccine.

Results: The current research is aimed to reveal any negative impact of 4vHPV vaccine on fertility indicators in Armenian cohort. The performed comparative statistical analysis of the assessed indicators has revealed the ORs<1 for POI, late fertilization disorders of menstrual cycle and anovulation prevalence indicators. The chance of investigated disorders' development in 4vHPV vaccine exposed cohort did not exaggerate that in non-exposed sample cohort. The significant difference was not observed in Anti-Mullerian Hormone, FSH basal levels, as well as in mean ovarian volume and number of antral follicles indicators between clinical and respective control groups (p<.05).

Conclusion: The data obtained make us to conclude about absence of any negative impact of 4vHPV vaccine on fertility function indicators in 4vHPV vaccinated cohort in RA. The study results contribute to perception of the 4vHPV vaccine safety concept, what in its turn can trigger increase of vaccination coverage leading to CC control efficiency.

Background: To evaluate the treatment outcomes of lateral interbody bone graft surgery and posterior percutaneous screws for lumbar spinal stenosis Methods: This is a cross-sectional descriptive study. There were 27 patients with 30 segments of surgery diagnosed with lumbar spinal stenosis that were surgically treated with the XLIF method. Clinical outcomes measured included VAS scores for lower back pain and leg pain, ODI, and JOA scores. Magnetic resonance imaging of the lumbar spine after surgery was used to evaluate indirect decompression. X-ray or CT scan to evaluate bone fusion after 6 months of surgery. Differences were determined by independent T-test.

Results: There were 27 patients with 30 segments of surgery. They were 12 males and 15 females with an average age of 58.81±8.1. There was significant improvement in VAS for lower back pain from 7.11±1.31 to 3.67±1.3, VAS for leg pain from 6.81±2.19 to 1.59±1.89, ODI from 26.41±8.95 to 13.69±8.34, and JOA score from 7.63±2.87 to 13.5±1.73. A-P diameter increased 134%, lateral diameter increased 120%, lateral recess depth increased 166%, disc height increased 126%, foraminal height increased 124%, spinal canal area increased 30%. The p-values were all <0.001. The average hospital stay was 6.79±3.01 days. Complications included 1 pedicle screw malformation, 1 ALL avulsion fracture, 1 abdominal herniation, 1 venous damage, 1 failure.

Conclusion: XLIF surgery presents a favorable option for patients with lumbar spinal stenosis. This is a minimally invasive surgical method that reduces pain, reduces bleeding, and is effective in indirectly decompressing the spinal canal both clinal and imaging.

Background: Osteoporosis (OP) is a highly prevalent disorder affecting 50 million individuals around the world. It is also a typical skeletal disorder described by low bone mass, which leads to reduced bone strength and an enhanced risk of fractures. Osteoprotegerin As a member of the TNF receptor superfamily, osteoprotegerin is well recognized for its protective effect against excessive bone resorption. Irisin is Irisin is a muscle-secreted hormone that is generated by the cleavage of membrane protein FNDC-5 (fibronectin type III domain-containing protein 5) (FNDC5). Irisin is widely distributed in the human body and is involved in the browning of white adipose tissue, improving insulin resistance, improving cognitive function, and regulating bone metabolism.

Methods: This study was a prospective cross-sectional study involving 90 postmenopausal osteoporosis (PMOP) Iraqi women in Kirkuk City over one year time; from April 2023 to the end of July 2024. Sixty women with osteoporosis are diagnosed by DEXA. And 30 women as a control group. The blood samples were collected from each woman included in this study for the estimation of osteoprotegerin and irisin. Were measured using the ELISA kit.

Result: This was conducted on sixty postmenopausal osteoporosis women. The age range was (50-65) years and the mean body mass index was (30.05) and thirty women as a control group. The age range was (50-65) years, and the mean body mass index was (27.55). The study found that the mean serum level of osteoprotegerin, increased in postmenopausal osteoporosis women compared to control (P-Value = 0.0007, while the mean serum level of irisin was lower in postmenopausal osteoporosis women compared to control this result was highly significant at a P value of 0.0004.

Conclusion: This study reveals that there was a positive correlation between serum osteoprotegerin, level with irisin (R=0.175).

Introduction: Recognizing the importance of birth weight is fundamental to addressing public health challenges associated with maternal and child health. Birth weight serves as a critical indicator, offering insights into mortality, stunting, and the development of chronic diseases later in life. This study delves into fertility and infant mortality trends in Kazakhstan, with a specific focus on understanding urban-rural disparities and gender variations in mortality rates.

Objectives: The primary objective of this study is to evaluate the influence of birth weight on infant mortality in Kazakhstan, considering demographic and regional nuances. Through comprehensive analysis, we aim to discern patterns and factors contributing to infant mortality, thereby informing targeted interventions and policies aimed at improving maternal and child health outcomes across the country.

Materials and methods: The analysis was conducted using the data provided by the Republican State Enterprise on the PCV of the "Republican Centre for Electronic Health Care" of the Ministry of Health of Kazakhstan.

Results: In Kazakhstan, birth rates reached their zenith in 2021 (total 446,491 births). However, this figure experienced a downturn in 2022, declining to 403,893 births. Notably, urban regions consistently reported higher birth rates compared to rural areas. The year 2022 witnessed a decline in birth rates across both urban and rural populations, with decreases of 9.5% and 11.7%, respectively, compared to the previous year. Analysis using linear regression techniques on infant mortality rates spanning from 2017 to 2022 revealed no statistically significant time trend (slope=51.29, correlation coefficient=0.42, p=0.41). Gender-specific disparities in mortality rates were starkly evident, with boys exhibiting higher mortality rates compared to girls across all population subsets. Geographical analysis conducted in 2022 exposed significant divergences in mortality rates across various regions.

Conclusions: The study highlights significant urban-rural disparities and gender differences in birth rates and infant mortality within Kazakhstan. It also confirms the protective effect of higher birth weight on infant mortality. Regional disparities suggest targeted public health interventions are necessary to address these variations effectively.

Thermal burns are the most common type of burn injuries. Medical treatment for burns is crucial, especially for third-degree burns and when a significant surface area of the body is affected. One of the most pressing issues in modern medicine is the search for new effective means to accelerate the healing of burn wounds. Oxygen radicals play a significant role in maintaining homeostasis, forming the body's resistance to infection, and ensuring the regeneration of organs and tissues. In this study, a superoxide (O2-)-producing enzyme (SPE) from raspberries was applied (topically to the skin, injected under the wound surface, with solution concentrations of 12.75% and 5%) after a third-degree thermal burn to determine its reparative effects on the skin. To assess the condition of the animals that had suffered burn injuries and the healing process, blood parameters were analyzed, and cytogenetic indices of bone marrow from the femur of the animals were studied: mitotic index, number of polyploid cells, and chromosomal aberrations. When analyzing hematological, cytogenetic, and histological parameters, significant differences were found between the «clean burn» groups and the groups in which SPE was used in different concentrations and methods of application. The use of SPE in both concentrations contributed to a reduction in the area of burn wounds compared to a «clean burn». The survival rate of animals for 30 days (before the end of the experiment) was 100% when using a 12.75% SPE solution and 50% when using a 5% SPE solution. The use of SPE led to significant differences in hematological parameters from the «clean burn» group throughout the entire duration of the experiment, showing a tendency to normalize the parameters. Under the influence of the 12.75% SPE solution, there was a tendency toward normalization of the mitotic index, along with a significant reduction in the percentage of polyploid cells and chromosomal aberrations, which may indicate its beneficial effects. This study found that a 12.75% SPE solution derived from raspberries was more effective and had healing properties on third-degree thermal burns, promoting rapid healing of the burn wound.

This study explores the relationship between psychological well-being and emotional profiles of adolescents in the context of school bullying. Bullying, characterized by repeated aggressive behavior, has severe psychological impacts, including anxiety, depression, and reduced self-esteem. The research involved 71 adolescents (ages 10-13) from various regions of Armenia. Using tools such as the Psychological Well-Being Study Method, Spielberger-Khanin Anxiety Inventory, Izard's Differential Emotions Scale, and Norkina's Bullying Structure Test, the study found that most adolescents have average psychological well-being, with higher social and spiritual health. Emotional profiles showed moderate levels of positive emotions, especially, interest and joy, but also was revealed the high levels of index of negative emotions, especially disgust, anger and guilt. The most common bullying role was "protector," followed by "helper," "bully," "victim," and "observer." Significant correlations were observed between emotional states and bullying roles, highlighting the influence of emotional well-being on bullying behavior. The study suggests that comprehensive anti-bullying programs should address psychological and emotional factors to effectively reduce bullying.

The pathogenesis of cutaneous tumors has been known for decades yet remains largely unexplained or incompletely understood. The reason for this mystery lies in the concepts of photosensitivity and phototoxicity: how do they arise or what actually causes them? Recently published data in the medical literature link certain nitrosamines such as nitrosomorpholine, for example, to gene and phototoxicity in humans. A number of other nitrosamines analogous in action and structure are found as contaminants in about 300 of the most widely distributed pharmaceuticals worldwide: NDEA, NDMA, NMBA and many others. These contaminated drugs include beta blockers/ bisoprolol/, thiazide diuretics/ hydrochlorothiazide/, antiarrhythmics/ propafenone/, ACE inhibitors/ lisinopril/, but also a number of other drugs which are, according to the FDA, found to have contaminants with a certain carcinogenic potency ranging between 1 and 5. The phototoxicity and genotoxicity of these contaminants, attributed to the pathogenesis of skin tumors, still remain a mystery. The problems of the intake of the above-mentioned groups of drugs arise mainly on the basis of the official bulletins of the regulatory bodies, namely that: in practice, the intake of polymedication could in many cases also be considered as regular, permanent, long-term intake of contaminants/carcinogens/mutagens of heterogeneous type, also known as nitrosamines or NDSRIs. Nitrosamines are genome modifiers in humans and cause acquired mutations. Their concomitant administration in the context of standard, but currently not yet officially declared as contaminated polymedication, would be able to block certain tumor suppressor genes (p53) as well as activate RAS oncogenes. Or in practice- daily administration of a particular combination of drugs could activate the cascades of carcinogenesis regulating the genesis of skin cancer. Precisely because of this fact, it should not be surprising to anyone that the concurrent intake of the aforementioned drugs could also be associated with the clinical manifestation of multiple keratinocytic tumors. We describe a consecutive case of a patient who developed 4 keratinocytic tumors: 2 basal cell carcinomas, 1 keratoacanthoma, and 1 squamous cell carcinoma on a background of potentially contaminated polymedication with propafenone, lisinopril, hydrochlorothiazide, and bisoprolol. Recently published innovative international data on the topic are discussed in the context of concepts such as drug-mediated nitrosogenesis, photonitrosо-carcinogenesis and metabolic programming/ reprogramming of the tumor cell.