Oriental Journal of Medicine and Pharmacology

COMPARATIVE INDICATORS OF 24-HOUR BLOOD PRESSURE MONITORING AND CHARACTERISTICS OF NIGHTTIME SLEEP IN PATIENTS WITH LACUNAR STROKES

Ravshan Shukurovich Abdurakhmanov — 2025-12-08

The aim of the present study was to assess the characteristics of the 24-hour blood pressure (BP) profile and nighttime sleep in patients with lacunar infarction (LI) and hemorrhagic stroke (HS). The study included 120 patients who underwent 24-hour BP monitoring (ABPM) and clinical evaluation during the acute period of stroke. We analyzed average 24-hour, daytime, and nighttime systolic (SBP) and diastolic (DBP) values, the 24-hour index, as well as BP circadian rhythm types: dipper, non-dipper, over-dipper, and night-peaker. It was found that the over-dipper type was more frequently observed in patients with LI, whereas in HS patients the night-peaker and non-dipper profiles predominated. The obtained data confirm the pathogenetic role of a disrupted circadian BP rhythm in the development of stroke, particularly during the nighttime period, and highlight the need for an individualized approach to antihypertensive therapy, taking into account circadian features of BP and sleep.

EFFECT OF ARTIFICIAL BLOOD CIRCULATION ON THE DEVELOPMENT OF NEUROLOGICAL COMPLICATIONS IN CARDIAC SURGERY PATIENTS

S. N. Gulomitdinov — 2025-03-22

Cardiac surgeries involving cardiopulmonary bypass (CPB) are highly effective, but they can lead to serious neurological complications. These include ischemic and hemorrhagic strokes, cognitive dysfunction, delirium, and other central nervous system disorders. This article provides a detailed analysis of the key pathophysiological mechanisms associated with CPB-related complications, including microembolism, hemodynamic disturbances, hypothermia, and its effects on brain tissue. The role of perioperative pharmacological agents (beta-blockers, heparin, insulin) in influencing neurological risk is also explored. The authors emphasize the importance of early stroke risk assessment, timely identification of high-risk patients, and the implementation of preventive strategies to reduce the incidence of such complications.

CLINICAL AND NEUROLOGICAL CHARACTERISTICS OF PATIENTS WITH ATHEROTHROMBOTIC LESIONS OF EXTRACRANIAL ARTERIES

Nargiza Abdullayeva — 2025-11-02

This article analyzes the clinical and neurological characteristics of patients with atherothrombotic lesions of the extracranial arteries of the brain. The study was conducted in Nukus from 2022 to 2024 and included clinical data from 128 elderly patients. According to the results, arterial hypertension and dyslipidemia were the leading risk factors, identified in more than 75% of patients in all clinical groups. In patients with combined stenosis of the internal carotid and vertebral arteries (Group III), the clinical symptoms were more severe, dominated by headache, dizziness, tinnitus, memory decline, and fatigue. Among neurological disorders, pyramidal signs, asymmetry of muscle tone, and coordination disturbances were common. The results of the study confirm the progressive development of vascular system damage in cases of combined and multifocal stenosis and indicate the necessity of early diagnosis and comprehensive preventive measures.

CLINICAL STRUCTURE OF LACUNAR STROKES IN PATIENTS WITH COVID-19

M.A. Bakhadirova — 2025-10-21

The study included 143 patients with lacunar strokes, 54 of whom had previously contracted COVID-19. A comparative analysis was conducted on the clinical manifestations, course variants, and severity of asthenic syndrome in patients with lacunar strokes with and without a history of COVID-19. It was found that patients who had recovered from the coronavirus infection showed a more polymorphic clinical picture, with a combination of motor, sensory, and coordination disorders, as well as diffuse microfocal symptoms. Additionally, patients with a history of COVID-19 exhibited a more pronounced asthenic syndrome based on the MFI-20 scale (p < 0.01). The findings suggest a modifying influence of SARS-CoV-2 on the pathogenesis and clinical course of lacunar strokes, highlighting the need for a comprehensive approach to diagnosis, treatment, and rehabilitation of such patients.

ANALYSIS OF ADVANTAGES AND DISADVANTAGES OF MODERN HYPOGLYCEMIC DRUGS

Iroda Brodarovna Takhirova — 2025-12-18

More alternatives for treating type 2 diabetes (T2DM) are provided by new hypoglycemic medications, such as sodium-glucose cotransporter 2 inhibitors (SGLT-2i), dipeptidyl peptidase-4 inhibitors (DPP-4i), and glucagon-like peptide 1 receptor agonists (GLP-1RA). They are usually well tolerated, though occasionally care must be used. In prediabetes and type 2 diabetes, combination therapy with novel hypoglycemic medications has demonstrated satisfactory glucose control in clinical studies (mainly traditional stepwise therapy); however, early combination therapy seems to offer faster, greater, and longer-lasting advantages. Now that oral semaglutide is widely used in clinical settings, it's time to create combination medications that include novel hypoglycemic medications, particularly SGLT-2i and/or GLP-1RA, to reduce the risk of prediabetes, newly diagnosed type 2 diabetes, and its cardiovascular complications while increasing patient compliance. SGLT-2i protects against heart failure through both direct and indirect effects, according to preclinical and clinical research. More research is required to determine how this all-encompassing protective effect controls the dynamic alterations of cardiac genes. From the standpoint of "clinical drug-mechanism-intensive disease treatment," we offer suggestions for the creation of medications for heart failure. This will expedite the creation of medications for heart failure and, to some extent, direct their usage. Patients with type 2 diabetes who fast during Ramadan benefit clinically from the newer glucose-lowering drugs, according to this systematic review and meta-analysis.

INSTRUMENTAL INDICATORS OF TRANSIENT ISCHEMIC ATTACKS IN URBAN AND RURAL POPULATIONS OF THE KASHKADARYA REGION

Muso Boltaevich Urinov — 2025-09-12

TIA (transient ischemic attack) often occurs with rapidly reversible neurological disorders, and the standard clinical examination does not always provide sufficient information. Instrumental methods — CT/MRI, Dopplerography, and neurophysiological tests — are the only objective tools for timely detection of structural and functional changes.

MEDICATIONS FOR ALCOHOLISM AND MEASURES TO IMPROVE THEM

Iroda Brodarovna Takhirova — 2025-12-18

Despite alcohol misuse being a significant sociological and economic issue for hundreds of years, no single effective treatment has been discovered. The intricacy of the pathophysiology of alcohol dependence makes it appear impossible to locate a single medication as a cure-all. This narrative review's goal is to examine current and perhaps upcoming medications for the most economical treatment of alcoholism. The FDA has approved acamprosate, disulfiram, and naltrexone, while the EMA has approved nalmefene. These medications are available to supplement psychotherapy, which is the cornerstone of treatment for alcoholism. The possibility of treating alcoholism with baclofen, topiramate, varenicline, and gabapentin has been reported recently in the literature. Furthermore, the outcomes of recent clinical trials utilizing psychoactive drugs like MDMA and psilocybin seem to represent a breakthrough in the current treatment of alcoholism. Despite this early hope, much more research is required before new pharmacological treatments for alcohol dependency syndrome are broadly accessible. In conclusion, combining pharmaceutical therapy with psychosocial therapies is the most successful approach to managing AUD. The available drugs for treating AUD have demonstrated good overall efficacy, despite the limitations of this review's narrative form. However, more advancements can be made by combining different drugs and tailoring the treatment to each patient. The gap between patients who require treatment and those who receive it can be closed by improving practitioners' understanding of these drugs. Crucially, these drugs may also contribute to the development of precision medicine and individualized care for the diverse AUD population. Nonetheless, there is still a huge need to de-stigmatize and encourage treatment-seeking for AUD, expand the menu of approved pharmaceutical therapies, and improve treatment availability.

THE LINK BETWEEN AIR POLLUTION AND ISCHEMIC HEART DISEASE

Farida Azizova — 2025-04-24

This article analyzes the relationship between air pollution and ischemic heart disease. The study examined the levels of the main air pollutants — PM2.5, PM10, NO₂ and CO — and statistics on hospital visits for heart disease. According to the results, high levels of air pollution lead to an increase in heart disease, especially ischemic heart disease. This article may be useful for industry experts, healthcare professionals and environmental policy makers.

ANATOMO-PHYSIOLOGICAL FEATURES OF THE FORMATION OF ANAL FISSURES AND WAYS OF THEIR CORRECTION

Shavkiya Ibatovna Tukhtanazarova — 2025-11-02

This article analyzes the underlying anatomo-physiological reasons for the development of one of the most common coloproctological diseases as anal fissures. Among proctological patients, patients with anal fissure are in second place. Women almost 2 times more often suffer from anal fissure than men, especially those of working age, which undoubtedly represents a socio-economic problem of public health. To date, questions of etiopathogenesis of anal fissures remain.

The main purpose of the work is to consider the predispositions of people to the development of anal fissures, as well as the role of variant anatomy in the mechanisms of prevention and mitigation of the course of the disease, analysis of statistical data on the incidence of the disease in Russia and Uzbekistan and their systematization depending on the lesion of a certain area of the anal part of the rectum. At the same time, the probability of occurrence of the disease in individuals is also estimated, the results of questionnaire survey of people with coloproctological problems are given in order to draw attention to the problems of not following the correct diet, body position in space during physical activity, perineal hygiene, timely preventive measures and visits to specialists in case of suspicion of problems in the rectum area. The rates of acute and chronic anal fissures among people of child, young and middle age who have high occupational risks of pathology development and prophylactic measures to prevent the consequences of this problem are studied. The study reveals the role of anatomo-physiological aspects in the development of anal fissures and identifies methods of preventing the pathology.

LABORATORY INDICATORS OF YOUNG PATIENTS WITH METABOLIC SYNDROME

Akmal Akhmadjonovich Gaybiyev — 2025-11-02

Metabolic syndrome (MetS) is increasingly observed among pediatric populations, presenting significant risks for cardiovascular disease and type 2 diabetes in later life. Laboratory parameters play a crucial role in diagnosing and monitoring MetS in children and adolescents.

SYNERGETIC INFLUENCE OF ENVIRONMENTAL AND NUTRITIONAL FACTORS ON THE CARDIOVASCULAR SYSTEM

Farida Azizova — 2025-09-30

This article examines the relationship and interaction of environmental and nutritional factors in the pathogenesis of cardiovascular diseases (CVD). Based on an analysis of current scientific sources, it emphasizes that environmental pollution (PM2.5, NO₂, heavy metals, organic toxins) and unfavorable nutrition (excess trans fats, salt, antioxidant deficiency) exert a synergistic effect on the development of inflammatory and degenerative changes in the cardiovascular system. Special attention is given to the mechanism of factor interaction, which includes oxidative stress, endothelial dysfunction, and mitochondrial disturbances. The necessity of a comprehensive preventive approach based on improving nutrition quality and reducing environmental risk exposure is justified.

THE IMPORTANCE OF ANTIBIOTIC RESISTANCE IN MEDICAL PRACTICE AND THE RELEVANCE OF ITS PREVENTION

Zulfiya Baratovna Djuraeva — 2025-12-18

A thorough understanding of the emergence, processes, advancements, and implications of antimicrobial resistance (AMR), which is often seen as a major worldwide public health problem, is necessary. The epidemiological landscape of antimicrobial resistance (AMR) is marked by its extensive prevalence and ever-changing patterns, with multidrug-resistant organisms (MDROs) posing new problems on a daily basis. The establishment and spread of novel resistance strains are facilitated by the most prevalent processes driving AMR, which include genetic alterations, horizontal gene transfer, and selective pressure. Antimicrobial stewardship programs (ASPs) and infection prevention and control strategies (IPCs) are examples of mitigation techniques that highlight the significance of responsible antimicrobial use and surveillance. The interdependence of human, animal, and environmental health is highlighted by a One Health approach, which emphasizes the need for interdisciplinary cooperation and all-encompassing tactics in the fight against AMR. Novel treatment developments (such as vaccines and other antimicrobial medicines) present intriguing ways to address AMR issues. ASPs that seek to control the use of antibiotics are also supported by national and international policy measures. Even with all of the progress that has been seen, antimicrobial resistance (AMR) is still a serious issue that requires ongoing work to address new threats and advance the sustainability of antibiotics. Future studies must focus on novel strategies and tackle the intricate socioecological factors that underlie AMR. For researchers, legislators, and medical professionals trying to understand the complicated AMR landscape and create practical mitigation methods, this book is an extensive resource.

EARLY DETECTION OF ACUTE ISCHEMIC IMPAIRMENT OF CEREBRAL BLOOD FLOW BY MULTI-SPIRAL CT PERFUSION OF THE BRAIN

M.M. Baxadirkhanov — 2025-08-30

Acute ischemic stroke (AIS) is one of the leading causes of mortality and disability worldwide. Early diagnosis and timely treatment are crucial from both medical and socio-economic perspectives. Modern neuroimaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) play a key role in the diagnostic process. However, standard CT scans may fail to detect early ischemic changes, limiting their use in the acute phase. Recently, multislice CT (MSCT) perfusion imaging has gained importance in the urgent diagnosis of ischemic stroke by quantitatively assessing cerebral blood flow, identifying perfusion deficits, and distinguishing the infarct core from the ischemic penumbra. This article analyzes the diagnostic value of MSCT perfusion in early ischemic stroke detection, compares it with traditional methods, and discusses its role in optimizing treatment strategies.