Patient and healthcare provider knowledge were previously found to be significantly associated with viral hepatitis testing in Uzbekistan. However, no survey has assessed awareness and knowledge of viral hepatitis among the general population. In 2022, we conducted a cross-sectional population-based survey among persons aged≥18 years in seven of Uzbekistan’s 14 regions representing 60
Background. Infectious complications remain a leading cause of early transplant-related mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT), particularly during the period of febrile neutropenia. Despite advances in transplantation techniques and supportive care, the optimal strategy for empirical antibacterial therapy in this high-risk population remains controversial, especially in resource-limited settings. Aim. To evaluate the incidence and spectrum of infectious complications, their impact on early mortality after allo-HSCT, and to assess the effectiveness and safety of an escalation-based empirical antibacterial therapy strategy in a single transplantation center with limited resources. Materials and methods. A single-center retrospective study included 45 adult patients who underwent allo-HSCT between 2023 and 2025 (acute myeloid leukemia – 21, acute lymphoblastic leukemia – 15, aplastic anemia – 8, myelodysplastic syndrome – 1). All patients received a uniform conditioning regimen based on fludarabine and melphalan (FluMel140). The incidence of febrile neutropenia, bloodstream infections, sepsis and septic shock, intensive care unit admission, and early mortality (≤30 days post-transplant) were analyzed. All patients received empirical antibacterial therapy following an escalation strategy. Microbiological identification was performed using VITEK 2 COMPACT and VITEK MS PRIME systems. Results. Febrile neutropenia occurred in 100 % of patients. Recurrent febrile neutropenia was observed in 44 % of cases, requiring escalation of antibacterial therapy to carbapenems. Microbiologically documented bloodstream infections were identified in 13 % of patients. Sepsis with subsequent septic shock developed in 22 % of patients and was associated with 100 % mortality in this subgroup. Gram-negative pathogens predominated among fatal infections, with Klebsiella pneumoniae and Pseudomonas aeruginosa being the most frequently identified organisms. Late colonization with Klebsiella pneumoniae was observed in all patients who died from infectious complications. Conclusion. Infectious complications remain the principal cause of early mortality after allo-HSCT. An escalation-based empirical antibacterial therapy strategy represents a feasible and reproducible approach in the majority of allo-HSCT recipients. However, in patients with a high infectious risk profile and colonization with multidrug-resistant organisms, this strategy may be insufficient. The obtained results highlight the need for individualized empirical therapy, enhanced microbiological monitoring, and optimization of conditioning regimens, particularly in resource-limited transplant centers.
Acute adhesive intestinal obstruction (AAIO) represents one of the most challenging conditions in abdominal surgery and is characterised by high complication and mortality rates. Objective. To examine the interrelationships among proinflammatory mediators, haemostasis system parameters, and fibrinolysis markers in acute adhesive intestinal obstruction. Materials and Methods. Correlations between proinflammatory cytokines (IFN-γ, TNF-α, IL-6), haemostatic parameters (prothrombin time [PT], international normalised ratio [INR], activated partial thromboplastin time [APTT], fibrinogen), and fibrinolysis markers (tissue plasminogen activator [tPA], plasminogen activator inhibitor-1 [PAI-1]) were analysed in 91 patients with AAIO, subdivided into uncomplicated and complicated forms, and compared with 20 healthy controls. Immunobiochemical markers were determined by enzyme-linked immunosorbent assay (ELISA). Written informed consent was obtained from all participants prior to enrolment. All procedures were approved by the Ethics Committee of the Institute and were conducted in accordance with the principles of the Declaration of Helsinki, as revised at the 75th General Assembly of the World Medical Association in October 2024. Statistical analysis was performed using SPSS version 26.0. Quantitative data are presented as the arithmetic mean (M) ± standard deviation (SD) or standard error of the mean (m), as appropriate. The normality of distribution was assessed prior to analysis. Intergroup comparisons were conducted using Student’s t-test for normally distributed variables and the Mann–Whitney U-test for non-parametric data. A p-value of less than 0.05 was considered statistically significant. study was conducted as part of the research plan of the Bukhara State Medical Institute (05.2022 DSc.135), entitled “Development of New Approaches to Early Diagnosis, Treatment, and Prevention of Pathological Conditions Affecting the Health of the Population of the Bukhara Region after COVID-19 (2022–2026)”. Results. Two distinct immune-coagulative phenotypes were identified. IFN-γ correlated positively with INR (r = 0.41) and tPA (r = 0.50), and negatively with fibrinogen (r = –0.36) and PAI-1 (r = –0.50), reflecting enhanced fibrinolysis and reduced coagulation potential. Unlike IFN-γ, TNF-α and IL-6 were associated with elevated fibrinogen and PAI-1 levels, prolonged APTT, and decreased INR and tPA, indicative of hypercoagulability, suppressed fibrinolysis, and endothelial dysfunction. Conclusion. These alterations were most pronounced in the complicated subgroup, suggesting an elevated risk of thrombotic events and ischemic intestinal damage. The findings demonstrate the prognostic value of monitoring coagulation and fibrinolysis markers in AAIO and support their use for early detection of complications and personalisation of antithrombotic strategies.
As digital transformation becomes an important pillar of smart city development, tourist destinations are looking for innovative approaches to improve visitor experiences and operational effectiveness. This paper explores how smart and sustainable strategies can be leveraged to promote Uzbekistan’s tourism digitalization, which is a nation endowed with rich cultural heritage but developing digital infrastructure. Adopting a mixed-methods approach, the study converges Glocal RPM and SANEL HERMES analysis frameworks to assess digital tourism’s current situation and challenges. Data were collected from surveys among tourists, stakeholder interviews, and expert judgments. The study identifies that Uzbekistan’s tourism sector is still at an early level of digital integration, and there is minimal coordination between urban innovation and tourism services. A strategic roadmap is outlined using the Quantitative Strategic Planning Matrix (QSPM) to prioritize digital initiatives that are consistent with smart city principles. The study points to the necessity for focused investment on digital infrastructure, capacity-building, and evidence-based decision-making. The findings provide practical implications for policymakers and urban managers looking to develop Uzbekistan’s tourism sector through smart city innovation.
Objectives:Uzbekistan, historically a country with high hepatitis B virus (HBV) infection endemicity, introduced infant hepatitis B vaccination in 2001 and has sustained ≥90% coverage for hepatitis B vaccine birth dose (HepB-BD) and three or more doses. In 2017, Uzbekistan initiated hepatitis B elimination activities. However, data on hepatitis B prevalence in the general population were lacking. Methods:In 2022, we conducted a serosurvey among persons aged ≥5 years using stratified cluster sampling. Blood samples were tested for markers of HBV and hepatitis D virus (HDV) infections. Results:We enrolled 9063 adults aged ≥18 years and 4092 children aged 5-17 years. Overall weighted prevalence of HBV surface antigen (HBsAg) was 4.1% (95% confidence interval, 3.1-5.0%); 13.0% (7.8-20.8%) of HBsAg-positive persons had detectable HDV ribonucleic acid (RNA). HBsAg prevalence was lowest (0.4%) among 5-14-year-olds and highest (7.3%) among 40-49-year-olds. Children who had not received HepB-BD had higher HBsAg prevalence (2.3%) than those who had received HepB-BD (0.1%, P < 0.001). Conclusion:Successful hepatitis B vaccination resulted in low HBV infection prevalence among children, but hepatitis B remains widespread among adults in Uzbekistan. Expanding HBV prevention, screening, and treatment among adults, and maintaining high infant vaccination coverage may help achieve hepatitis B elimination in Uzbekistan.
