Samarkand State Medical University (Samarkand State Medical University until April 1, 2022) — medical is a higher educational university in Uzbekistan, engaged in education and training of students, medical workers and scientists, as well as improving their qualifications. The University is located in the city of Samarkand. Samarkand State Medical University was founded by the decision of the Government of the Republic 90 years ago, in the distant 1930 year. During its glorious history, our university has passed a long way of becoming one of the leading medical universities not only in Uzbekistan, but also in the entire Central Asian region. In 1930, by the Decree of the Council of People's Commissars of Uzbekistan No. 80 dated May 7, 1930, the State Uzbek Medical Institute (SUMI) was founded in the city of Samarkand. This was a big event for the population of the Central Asian region, as there was no independent medical higher education institution in this region. The Samarkand State Medical Institute (since April 2022 - the University) received a special development after the republic achieved independence. In 1997, the country adopted the "National Training Program", and in 1998, the state program for health care reform, which resulted in the creation of the Faculty of Higher Nursing in 1999. In 2001, the department was opened, and since 2005, the Faculty of Medical Pedagogy, and in subsequent years the faculties of dentistry, medical prophylactics, medical biology, pharmacy, and since 2020, students are studying in the new direction of "Traditional Medicine". In 2020, the coronavirus pandemic COVID-19 radically affected all spheres of life in almost all countries of the world. There are even suggestions that the changes are so profound that we will have to adapt to them, in the sense of constantly meeting sanitary and epidemiological requirements. The pandemic has also had a major impact on education and training. Our University, like all educational institutions of the republic, has switched to distance learning since the first days of the pandemic. Since 2013, its own electronic learning platform has been created and successfully operated, and the entire learning process from April to the end of the academic year took place on it. Due to the specifics of our university and the fact that the main backbone of its personnel potential is made up of employees of the healthcare system, it is natural that from the very beginning of the quarantine, they were able to quickly restructure all their work to meet the requirements of distance learning. Since the beginning of the 2020-2021 academic year, a completely new electronic platform of the Institute for conducting classes online has been created, all the main educational materials have been translated into electronic format and placed in specially created virtual resource bases, to which all teachers and students have access. On December 24, 2021, the President of the Republic of Uzbekistan signed two important documents concerning fundamental changes in the higher education system "On additional measures to ensure the academic and organizational and managerial independence of state higher educational institutions" and" On measures to ensure the financial independence of State higher educational institutions". The adopted documents opened a new page in the development of higher education institutions in the country. In accordance with these documents, higher education institutions will have such rights and opportunities as creating and publishing textbooks and other educational and scientific literature based on their own plan for higher education institutions and their branches; creating and implementing mechanisms for internal control of quality of education; carrying out basic activities related to education, science, implementation and commercialization of its results, creation of non-governmental structures, commercial and non- commercial organizations; approval of structure of the institution and determination of the number of staff regardless of the standards established for higher educational institutions; opening of new directions and specialties based on the needs of the labor market, termination of existing directions and specialties; establishing the procedure for hiring, dismissing and internal rotation of teachers and other employees; admission of foreign citizens on a paid basis and organization of distance learning. The rector emphasized that these documents give not only rights and independence, but also assign special responsibility for their implementation to the staff of the Institute. According to these documents, the list of state higher educational institutions has been approved, including Samarkand State Medical University, which will be granted financial independence from January 1, 2022. Universities will have the authority to independently make decisions on determining the cost of training on a fee-based contract basis, establishing and extending the terms of payment for a paid contract by students, attracting on a contractual basis native and foreign professors-teachers and specialists who are able to apply modern pedagogical technologies in the educational process and conduct scientific research, establish the amount of remuneration of foreign highly qualified specialists involved in educational and scientific processes, develop standards for the introduction of full-time units of professors and teachers, allocate scholarships and grants for students at their own expense, directly purchase educational and scientific literature, textbooks and textbooks from foreign countries from manufacturers, copyright holders, determining the procedure for providing paid services in empty buildings and structures, determining the annual limit vehicle and requirements for their maintenance. Starting from the 2022-2023 academic year, the universities included in the list will have the following powers in the academic sphere: to approve academic programs and plans, as well as qualification requirements; to determine the language and form of education; to set the terms of study for bachelor's and master's degrees, to approve the procedure for scientific guidance for doctoral students and applicants; to introduce correspondence, evening, distance learning for master's degrees develop and publish textbooks and other educational and scientific literature for universities; define and implement internal quality control of education. They can also make their own decisions on the transfer of foreign citizens from foreign universities, approve the order of their exams and assessment criteria. Starting from the 2022-2023 academic year, universities will be able to create structural divisions engaged in activities in the field of education, science, as well as the implementation and commercialization of research results. Also, universities will independently determine the rules of internal order, in particular the form of clothing. A supervisory board will be created, which will include representatives of the university's management departments and ministries, as well as the public. Supervisory boards will have broad rights and powers in the activities of the university. According to the Regulations, students, researchers and teachers get free access to international databases. Literature in university libraries will be digitized and published on the E-Library platform of the Ministry of Higher Education. All reporting at universities will be translated into an online format, and for this purpose, the Ministry of Higher Education, together with the World Bank, will gradually introduce an Information System for Managing Higher Education Processes. And the exemption from customs duties on the import of educational, scientific, laboratory and special equipment, educational and scientific-methodical literature, educational multimedia products and equipment until 2024 will further strengthen the material and technical base and potential of the university. The decree of the President of the Republic of Uzbekistan Shavkat Mirziyoyev dated April 1, 2022 "On the establishment of the Samarkand State Medical University and further improvement of the training system in this field" on the creation of a modern medical university in ancient Samarkand on the basis of the Samarkand State Medical Institute, which embodies the most advanced achievements of national and international experience, is in our opinion strategically important value. Our university has everything necessary for this, including a powerful scientific and pedagogical center potential, rich material and technical base, long-standing traditions of training qualified medical personnel. According to the Presidential decree, the educational process is focused on the formation of practical skills, the widespread introduction of advanced pedagogical technologies, curricula and innovative materials based on international educational standards, the creation of the necessary conditions for ensuring a combination of theoretical knowledge and practice in the clinic and training base, the development of academic mobility programs for students, teachers and researchers within the framework of cooperation with foreign medical universities, conducting fundamental, applied and innovative research to solve existing problems in medical practice, gradually introducing the "University 3.0" concept, which provides an integral link between medical education, science, and practical healthcare with real sectors of the economy. The Resolution also pays special attention to the development of the practical orientation of the University, in particular, on the basis of the Samarkand Regional Health Recovery Hospital, it is planned to create a Research Institute of Rehabilitation and Sports Medicine, a multidisciplinary clinic of the University and a Specialized children's Surgical Clinic based on the first and second clinics of the Samarkand State Medical Institute, a Research Institute of Microbiology, Virology, Infectious and parasitic diseases named after L. M. Isaev on the basis of the branch named after L. M. Isaev. IsayevaRepublican Specialized Scientific and Practical Medical Center of Epidemiology, Microbiology, Infectious and Parasitic Diseases and its Clinic, Specialized Scientific and Practical Center of Neurosurgery and Neurorehabilitation, Scientific Center of Immunology, Allergology and Human Genomics.
Abstract OBJECTIVES: Questionnaires are widely used in medicine to collect essential patient information, identify disease etiologies, and assess treatment outcomes. In orthodontics, questionnaire-based assessments facilitate the identification of factors associated with dentoalveolar anomalies and myofunctional disorders. Adenoid hypertrophy (AH) is a significant contributor to the development of these conditions. However, inadequate postoperative follow-up may allow myofunctional disorders to persist or progress, despite surgical treatment. A comprehensive evaluation of factors affecting general and oral health may improve diagnostic accuracy, treatment outcomes, and interdisciplinary collaboration. This study aimed to assess the condition of children after surgical treatment for AH, determine the need for orthodontic intervention and associated risk factors, and evaluate the extent of interdisciplinary collaboration in identifying and managing myofunctional disorders through a questionnaire survey and medical record analysis. MATERIALS AND METHODS: This retrospective observational questionnaire-based study included 220 children aged 5–8 years who had undergone surgery for AH. Medical records and questionnaires completed by the children’s legal guardians were analyzed. RESULTS: The findings indicate that a considerable proportion of children continued to experience respiratory, functional, and speech-related complaints after adenoidectomy. Parents frequently reported persistent mouth breathing, pronunciation difficulties, and signs suggestive of myofunctional disorders, despite previous surgical treatment. CONCLUSIONS: Persistent postoperative complaints were identified in a proportion of children, including impaired nasal breathing, harmful oral habits, pronunciation difficulties, and parent-reported signs suggestive of myofunctional disorders. The findings also showed insufficient interdisciplinary follow-up after adenoidectomy, particularly regarding referrals to orthodontists, dentists, speech therapists, and specialists in myofunctional therapy.
Background Pathological menopause, which encompasses premature ovarian insufficiency (POI), early menopause, and iatrogenically induced variants, represents a critical and often devastating deviation from the normative reproductive aging trajectory. Affecting approximately 3.5% to 5% of women globally, it precipitates an abrupt and profound cessation of ovarian endocrine function. This early-onset hypoestrogenism subjects affected individuals to severe vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and exponentially accelerates the longitudinal risk of cardiovascular disease, osteoporosis, and neurocognitive decline. Methods This comprehensive systematic review synthesizes high-impact evidence from recent international clinical guidelines spanning 2024 to 2026, including comprehensive frameworks from the European Society of Endocrinology (ESE), the American Society for Reproductive Medicine (ASRM), and the International Menopause Society (IMS). A systematic analysis of phase 3 clinical trials, pharmacogenomic studies, artificial intelligence-driven predictive models, and regenerative medicine research was conducted to outline precision management algorithms for highly stratified patient cohorts. Results The optimization of menopausal hormone therapy (MHT) relies heavily on pharmacological risk stratification, emphasizing the shift toward transdermal 17β-estradiol combined with micronized progesterone to mitigate venous thromboembolism (VTE) and oncological risks. Estetrol (E4), a native fetal estrogen with selective tissue activity, emerges as a highly favorable alternative demonstrating neutral cardiovascular and hemostatic profiles in the recent E4COMFORT phase 3 trials. For patients with absolute contraindications to MHT, particularly breast cancer survivors experiencing iatrogenic menopause, the approval of neurokinin-3 (NK3) receptor antagonists (fezolinetant and elinzanetant) represents a paradigm shift in mitigating VMS via direct hypothalamic modulation without systemic endocrine effects. Furthermore, the integration of pharmacogenomic testing (e.g., CYP2D6, ESR1) and artificial intelligence-driven predictive models significantly enhances therapeutic individualization. Regenerative frontiers, particularly hypoxic mesenchymal stem cell-derived exosomes acting via the SIRT3/PGC-1α pathway, offer unprecedented potential for ovarian follicle rescue and functional restoration. Conclusion The contemporary management of pathological menopause necessitates an immediate departure from standardized, empirical protocols in favor of precision, biomarker-guided stratification. By synthesizing advanced pharmacotherapy, non-hormonal innovations, and resolving profound global health equity gaps, this multidisciplinary approach ensures optimized long-term health span and quality of life for women experiencing premature estrogen deprivation.
Background The meniscus is a C-shaped fibrocartilage structure in the knee that acts as a vital shock absorber, distributing loads and stabilizing the joint. Meniscal tears are among the most common orthopedic injuries, frequently resulting from sports-related trauma in younger populations or degenerative changes in older adults. When conservative management fails, Arthroscopic Partial Meniscectomy (APM) is the standard surgical intervention to remove unstable fragments and alleviate mechanical symptoms like locking or catching. Despite the surgical success, the immediate postoperative period is characterized by Arthrogenic Muscle Inhibition (AMI). This is a clinical phenomenon where swelling, pain, and joint inflammation trigger an inhibitory reflex that prevents the central nervous system from fully activating the quadriceps. This involuntary "shut down" of the muscle leads to rapid atrophy, significant strength deficits, and altered gait patterns. If left unaddressed, these neuromuscular impairments can delay the return to functional activity and increase the risk of early-onset osteoarthritis due to improper joint loading. Traditional rehabilitation relies on voluntary exercise; however, because AMI limits the patient's ability to contract the muscle effectively, adjunctive technologies like Neuromuscular Electrical Stimulation (NMES) and Electromyographic Biofeedback (EMG-BF) have become essential. These tools aim to bypass or retrain the inhibited neural pathways to restore muscle function more efficiently than exercise alone. Methods EMG-BF methodology focuses on the re-education of voluntary muscle control. Surface sensors detect myoelectric signals, which the device converts into visual or auditory cues. A "target" threshold is established based on the patient's Maximal Voluntary Isometric Contraction (MVIC) on the first postoperative day. Patients are instructed to contract their quadriceps until the feedback signal (e.g., a rising bar on a screen) reaches the preset target. As the patient improves, the therapist gradually increases the threshold to challenge the muscle further. Unlike the passive nature of NMES, EMG-BF is integrated into active tasks such as straight-leg raises or isometric holds to improve coordination. Results Current clinical results indicate that both Neuromuscular Electrical Stimulation (NMES) and Electromyographic Biofeedback (EMG-BF) significantly enhance recovery post-meniscectomy compared to standard exercise alone. While NMES is superior for rapid strength gains in the immediate postoperative phase, EMG-BF typically yields better outcomes for functional coordination and gait performance. Conclusion Integrating Neuromuscular Electrical Stimulation (NMES) and Electromyographic Biofeedback (EMG-BF) into post-meniscectomy rehabilitation represents a significant advancement over traditional exercise-only protocols. Both modalities effectively address arthrogenic muscle inhibition (AMI), but they offer distinct clinical advantages: NMES is a powerful tool for preserving muscle mass and generating force in the early acute phase, while EMG-BF is superior for restoring voluntary control, coordination, and functional gait. Current evidence suggests that EMG-BF may hold a slight edge in accelerating the return to unassisted walking and improving knee range of motion. However, the most effective clinical strategy is a multimodal approach. Combining the passive recruitment of NMES with the active, cognitive reinforcement of EMG-BF—particularly through EMG-triggered stimulation—maximises quadriceps recovery and potentially reduces the long-term risk of degenerative joint changes. In conclusion, these technologies should not be viewed as replacements for physical therapy but as essential biotechnological adjuncts. They bridge the gap between surgical intervention and functional recovery by "restarting" the inhibited neuromuscular system, leading to faster, more stable outcomes for post-meniscectomy patients
Prostate cancer imaging is inherently multimodal, yet many AI tools remain single-modality and therefore misaligned with real-world abdominal/genitourinary radiology decision-making. We review workflow-relevant multimodal AI methods that fuse mpMRI, PSMA PET, ultrasound (including TRUS and elastography), and clinical or pathology data for diagnosis, local staging, and treatment personalization. : MRI-plus-clinical fusion improves csPCa triage beyond imaging-only baselines and supports practical risk-model implementations. MRI–TRUS fusion models demonstrate improved lesion localization for targeted biopsy compared with unimodal AI and standard radiologist MRI interpretation in multicenter settings. For local staging, multimodal strategies for extraprostatic extension prediction are supported by meta-analytic evidence and emerging PET/MRI- or PET/CT-plus-MRI approaches that can assist radiologists and inform nerve-sparing planning. For treatment personalization, multimodal models predict biochemical recurrence after prostatectomy and extend toward systemic endpoints using imaging fused with clinical variables or pathology-derived features. The most adoption-ready directions for Abdominal Radiology readers are modular multimodal systems that improve triage, guide biopsy targeting, and quantify local extension risk with transparent validation pathways and human-centered deployment design.
Alzheimer's disease (AD) is a prevalent neurodegenerative disorder marked by a gradual decline in memory and cognitive functions. It is characterized by the presence of senile plaques, neurofibrillary tangles, and neuronal degeneration, affecting a significant portion of the human population. A key feature of various nervous system disorders, including AD, is extensive cellular death caused by apoptosis, which affects not only neurons but also glial cells. While apoptosis plays a vital role in eliminating certain cells and supporting normal development, alterations or disruptions in apoptotic pathways can lead to harmful neurodegenerative conditions such as AD. Thus, targeting apoptosis presents a promising therapeutic approach for these diseases. MicroRNAs (miRNAs), a class of non-coding RNA, play diverse roles in cellular functions, including proliferation, gene expression regulation, programmed cell death, intercellular communication, and angiogenesis. By modulating regulatory genes, miRNAs can influence apoptosis, either promoting or inhibiting it. Aberrant expression of miRNAs can impact multiple apoptotic pathways, potentially driving the progression of AD and related health issues. This review summarizes recent research on miRNAs and their dual role in exacerbating or protecting against neural cell damage in AD by altering apoptotic pathways. The regulation of apoptosis by miRNAs offers a prospective therapeutic strategy for Alzheimer's disease.
