One of the urgent problems in obstetric practice is the disclosure of pathogenetic mechanisms of violation of the contractile activity of the uterus during childbirth, which is accompanied by an increase in the risk of emergency caesarean section. Among the reasons, a significant role is assigned to anomalies of labor activity (10–25 %), in which labor activity is inhibited for unknown reasons. The appointment of drugs that stimulate the contractile function of the uterus during childbirth, with a mechanical obstruction not diagnosed in a timely manner, is accompanied by an increased risk of fetal asphyxia, birth trauma and leads to a belated caesarean section. Timely prediction of the course of the birth process and the selection of pregnant women for controlled delivery are one of the main medical problems. In view of the foregoing, we have established factors that are directly related to the formation of the cause of an emergency caesarean section. A retrospective study was conducted based on the analysis of medical documentation (history of childbirth) of 99 puerperas hospitalized in the 3rd City Clinical Hospital named after E. V. Klumov» in Minsk in 2021–2022. The main group consisted of 52 women after spontaneous childbirth (the average age of the patients was 26.7 ± 3.6). 49 puerperas of the comparison group were examined after emergency operative delivery (the average age of the patients was 27.6 ± 2.5). All puerperas of the compared groups were prescribed oxytocin infusions during labor in accordance with the clinical protocol. According to the results of our research, most of the signs that contribute to the completion of labor by caesarean section are related to mechanical difficulties. Undoubtedly significant predictors of the completion of labor by caesarean section were: acute fetal hypoxia, chronic decompensation according to cardiotocography and incorrect insertion of the fetal head. The most significant predictors were a decrease in contractile activity (OR = 21.0, CI 11.68–37.09, p < 0.001), cervical dystocia (OR = 10.0, CI 2.41–18.90, p < 0.001) and discoordination of labor according (OR = 6.0, CI 1.6–17.9, p = 0.006), the presence of which increases the chances of operative delivery by 21.0; 10.0 and 6.0 times, respectively. Weakness of labor activity and uterine atony in labor are a fairly common cause of emergency caesarean section due to the lack of effect of the therapy or violation of the fetal condition, but the mechanisms of their formation remain unidentified.

The article presents a literature review regarding the composition and pharmacological properties of Heracleum Sosnowski Manden. The dominant group of biologically active substances of Heracleum Sosnowski are furanocoumarins, which are represented by angelicin, bergapten, isobergapten, isopimpinellin, methoxsalen, osthole, pimpinellin, sfondin, umbelliferone, isoimperatorin, marmesin, oxypeucedanin and pangelin. In addition to this group of biologically active substances, Heracleum Sosnowski contains terpenoids, phenols and their derivatives, organic acids, aliphatic hydrocarbons, alcohols, aldehydes, fatty acids and their esters, carbohydrates, proteins and amino acids, vitamins and alkaloids. The essential oil contains predominantly aliphatic esters and has an antibacterial effect.
For Heracleum Sosnowski described photosensitizing, antihypertensive, antispasmodic, diuretic, antioxidant and antibacterial action. The photosensitizing effect of Heracleum Sosnowski is associated with the presence of coumarins in it. Methods for obtaining galenic drugs (tinctures, extracts), suspensions of the amount of furanocoumarins and essential oil emulsions from Heracleum Sosnowski herbal raw materials have been developed under laboratory conditions.
The toxic properties of Heracleum Sosnowski on the skin, cytotoxic, genotoxic and mutagenic effects were noted. The phototoxicity of Heracleum Sosnowski manifests itself in the form of photodermatitis, for the treatment of which there are currently no clinical guidelines and protocols.
Medicinal plant materials Heracleum Sosnowskyi are not included in international, regional and national pharmacopoeias and, therefore, do not have approved express and high-precision standardization methods, incl. methods of identification and quantitative determination of the active group of biologically active substances – furanocoumarins.
Thus, the pharmacological potential of Heracleum Sosnowskyi is not well understood. There is no evidence base necessary to obtain safe and effective drugs based on it. At the same time, in order to obtain dosage forms from Heracleum Sosnowskyi, it is necessary to develop safe methods for the procurement and processing of raw materials.
Given the presence of cytotoxic properties, a promising direction in the study of the pharmacological properties of extracts from Heracleum Sosnowskyi may be the assessment of their cytostatic activity against tumor cell lines in vitro.

The modern methodological approaches, such as biomonitoring, could be used to improve the evidence base reliability and reduce uncertainty under chemicals health risk assessments and hygienic rationing. The aim of the study was to substantiate using the results of chloroform determination in human blood as a biomarker of exposure to drinking water disinfection byproducts under republican conditions. A gas chromatography-mass spectrometry method for determination of chloroform in whole blood based on the use of acetonitrile as solvent and additional extraction of chloroform from acetonitrile supernatant by small amounts of hexane was developed. Chloroform concentrations in the blood of population at the territories supplied with chlorinated drinking water are significantly higher than that of population at the territories supplied with water without chlorination (0.03–0.54 ng/ml, P95 0.27 ng/ml versus 0.00–0.37 ng/ml, P95 0.13 ng/ml respectively). A proposed linear dependence model enables to predict the chloroform blood level in the exposed population based on water concentrations and vice versa. We recommend the determination of chloroform in the whole blood of the population as an informative biomarker of cumulative exposure, reflecting real exposure scenarios for the preceding period of time, based on identified trends.

The article presents a modern view on functional activities of astrocytes during physiological processes, describes the morphological characteristics of the isolated subpopulations of astrocytic cells of the human brain: interlaminar, protoplasmic, astrocytes with varicose projection (varicose astrocytes), polarized and fibrous. Interlaminar astrocytes of the I cortical layer of the human brain characterize by long processes that penetrate up to IV cortical layer, and short processes that form the glia pial limitans. A characteristic feature of protoplasmic astrocytes is a wide highly branched network of short processes and domain organization. Polarized astrocytes and astrocytes with with varicose projection, which found in V–VI cortical layers of neocortex, have long processes that penetrate into the upper cortical layers of human brain, providing interlaminar intercellular interconnection. The article also noted the cellular specificity of immunohistochemical markers used to visualize astrocytes.
We noted the cellular specificity of immunohistochemical markers used for visualization of astrocytes.

Inflammatory diseases of aorta are associated with such serious complications as dissecting aneurysm, rupture of the aortic wall and thromboembolism, which determine the importance of the early detection of this pathology. The complexity of a timely diagnosis of aortitis can be justified by the absence of pathognomonic clinical symptoms or the development of the disease as a part of a systemic disorder, the non-specificity of changes in standard laboratory tests and the unavailability of the routine morphological examination of the aorta. Differential diagnosis of infectious and non-infectious aortitis is very important, because it influences the effectiveness of treatment. Early recognition of the pathology has become possible due to the accessibility of the specific markers of the systemic diseases, laboratory tests to detect infections and modern instrumental methods of visualization of the aortic lesions. The article presents the causes of infectious and non-infectious aortitis, characteristic of clinically isolated aortitis and periaortitis, and morphological patterns of aortitis according to the structure of the inflammatory infiltrate. The authors reviewed both laboratory tests and methods of instrumental diagnostics that provide significant assistance in identification of the disease aa well as diagnostic algorithm of aortitis.

Idiopathic inflammatory myopathies are the group of rare heterogeneous autoimmune diseases of unknown etiology, characterized by inflammatory lesions of the striated muscles and skin, as well as the development of specific organ pathology. The history of the study idiopathic inflammatory myopathies has more than 100 years. Initially, this group of diseases included only 2 main subtypes: dermatomysitis and polymyositis. The latter was the main subtype of myopathies, it corresponded to 2/3 of the clinical descriptions of this pathology available at that time. The discovery of myositis-specific and myositis-associated autoantibodies at the end of the 20th century made it possible to significantly expand the understanding of the pathogenesis of idiopathic inflammatory myopathies. Not only the autoimmune genesis of myopathies was proven, but also their immunological heterogeneity, as well as the existence of clinical and immunological subtypes.
Today, with no serological markers, no skin lesions, and no unique histological presentation, polymyositis is a difficult-to-diagnose disease that can often be misdiagnosed in patients with another pathology or subtype of idiopathic inflammatory myopathies. According to most experts, polymyositis is currently a diagnosis of exclusion and is the rarest subtype of idiopathic inflammatory myopathies, accounting to no more than 5 % of all cases in this group.

Distal biceps ruptures occur mostly in 40–60 y. o. men during rapid elbow flexion against significant external force.
Clinical examination remains the mainstay of the diagnostics of the distal biceps tendon rupture (“Popeye” deformity, ecchymosis, and hook-test), ultrasound and MR investigations may be used in doubtful cases.
Non-operative treatment leads to the decrease of flexion and external rotation forces, thus surgical treatment is preferable in most cases.
The choice of surgical approach depends on the fixation method. Transosseous fixation with bone tunnels and two-incision technique is valid and provides low level of re-ruptures with more anatomic restoration of the insertion point, but is associated with higher rate of heterotopic ossification. Newer methods of fixation (buttons, anchors, interferential screws) may allow the single approach, but not always provide anatomic reinsertion and may lead to higher rate of complications at the site of surgical approach in the elbow crease.
Functional post-operative care in majority of cases leads to the restoration of range of movements at 6 weeks, and muscle forces at 12 weeks. This usually allows full restoration of the physical activity at 3 to 6 months after the surgery.

The article gives a characteristic of post-gastroresection pathology – adductor loop syndrome. Ethology, pathogenesis, clinical manifestations, classification are described. Methods for diagnosing the syndrome using X-ray, endoscopic methods, ultrasound examination of the abdominal organs, and computed tomography are considered in detail. The methods of conservative therapy of the afferent loop syndrome are described, the indications for surgical treatment are determined. The characteristic of classical and new methods of implementation of operational benefits, their effectiveness is given. It was noted that during the surgical treatment of the afferent loop syndrome, etiopathogenetically substantiated reconstructive interventions are shown to help restore the natural, physiological relationships of organs and tissues; if possible, the pre-operative passage of food through the gastrointestinal tract.

A prospective study was conducted in 197 patients (mean age 25.0 ± 2.4 years). Established clinical and laboratory-instrumental criteria for various options for postpartum subinvolution of the uterus:
1) subinvolution without clinical signs of an infectious and inflammatory process – leukocytosis up to 10×10⁹/l, the number of stab neutrophils 3–4 %, ESR up to 20 mm/h, PCT less than 0,05 ng/ml, hsCRP level less than 10 mg/l, LII less than 1 unit, PLA2 activity 2, 5–4 IU/l, IR of uterine arteries less than 0.5; expansion of the uterine cavity up to 15 mm according to ultrasound; uterine tone less than 5.4 mHg;
2) subinvolution with minor clinical signs of inflammation – leukocytosis 10–11×10⁹/l, the number of stab neutrophils 5–7 %, ESR 20–30 mm/h, PCT 0,05–1,5 ng/ml, the level of hsCRP 10–20 mg/l, LII – 1–3 units, activity PLA2 4–7.0 IU/l, IR of uterine arteries less than 0.5, expansion of the uterine cavity 15–20 mm; uterine tone less than 5.4 mHg;
3) subinvolution complicated by HPE – leukocytosis 12×10⁹/l or more, the number of stab neutrophils 8 % or more, ESR – more than 30 mm/h, PCT more than 1,5 ng/ml, hsCRP level more than 20 mg/l, LII more than 3 units, PLA2 activity more than 7.0 IU/l, IR of the uterine arteries is less than 0.5, the expansion of the uterine cavity is more than 20 m, uterine tone less than 5.4 mHg.
2. A strong inverse relationship was found between uterine tone and uterine cavity size (correlation coefficient r = –0.9751; p < 0.001; 95 % confidence interval) in patients with SCI.
3. A decrease in the index of resistance of the uterine arteries to 0.47 ± 0.02 c. u. was established (p = 0.022) in a strong direct associative relationship with the size of the uterine cavity (correlation coefficient r = 0.93712; p = 0.001; 95 % confidence interval).

The authors present the clinical and epidemiological features of the disease of tic-based encephalitis among residents in Belarus. The main reservoirs of infection are described. We have demonstrated a clinical case of Central European tick-borne encephalitis. To solve the set tasks in this research, we used methods of epidemiological diagnostics and statistical research methods. According to the results obtained, the incidence of leptospirosis in Belarus for the studied interval (2012–2021) was unevenly distributed over the years. The maximum and minimum indicators differed 1.5 times. The average long-term incidence rate was 1.28 cases per 100 000 population. The analyzed period of time was characterized by a long-term epidemic trend towards an increase in the incidence. The risk group for tick-borne encephalitis was adults (95.0 ± 4.87 %). Most patients with tick-borne encephalitis in 2021 lived in the Moscow and Leninsky districts of Minsk (30.0 ± 10.25 % and 20.0 ± 8.94 %, p < 0.05). The efficiency rate of transmission of the tick-borne encephalitis virus during the bite of a virusophoric tick in 2021 was 1 case of TBE in 54 cases of tick bites.

Purulent-inflammatory (including abscessing) diseases of the oropharynx are among the most common pathologies in otorhinolaryngology. More common in young people. Paratonsillitis and paratonsillar abscesses in the vast majority of cases occur against the background of general and endogenous intoxication, which creates an additional burden on the body and increases the risk of metatonsillar diseases of the internal organs. The simplest and most accessible method for detecting and assessing the degree of endogenous intoxication is the calculation of hematological leukocyte indices of intoxication, carried out using the leukocyte formula of a general blood test. 137 patients were examined, including 104 cases of paratonsillar abscess (75.9 %) and 33 cases of paratonsillitis (24.1 %). Age of patients 19–52 years old, males predominated (78 patients). It has been established that the degree of endogenous intoxication does not depend on the nature of the pathological process (non-purulent or purulent) in the paratonsillar tissue, the differences are not significant. Most often, endogenous intoxication of moderate severity was detected: with paratonsillitis – 57.7 % of cases, with paratonsillar abscess – 60.7 % of cases. There was no strong correlation between the LIIO value and the number of leukocytes in the general blood test.

In the article, the study results show that under the volunteers’ conditions of the experiment on the physiology and psychoemotional state, they influence their subjective assessment. We had interviewed 48 volunteers. Volunteers used medical masks (type II, registered in the Republic of Belarus) for experimental studies. We have studied the physical and psycho-motional state of volunteers on the based on their subjective assessment when using masks in an experimental situation for three days while modeling working conditions in three categories of work Ib, IIa, IIb. As a result of the study, it was found that in the conditions of the experiment with an increase in the level of energy consumption among volunteers when using medical masks, the number of complaints indicating the development of fatigue increases, discomfort in the face is more often observed, while most volunteers don’t associate the use of medical masks with changes in their physical and psychoemotional state.

The authors have shown for the first time that the development of co-dependency syndrome is associated with the lack of formation or loss of the boundaries of the individual space-time model of a person, which makes it impossible for him to exist independently.
This leads to a person’s loss of subjectivity and merging with another subject of the relationship – an alcohol-dependent family member.
Such a person ceases to separate himself from the latter and becomes dependent on his dependence, experiencing the disease with him and adapting to his needs and lifestyle.
These processes are due to the launch of the space-time model of the co-dependent, which leads to the insufficiency of functioning of its main element – the temporal spiral, which acts as the engine of the entire model.
The time spiral becomes unable to produce internal energy of the human body, which leads to the development of hypo/anergy in the state of dependent.

Establishing the topographic features of the nerves of the larynx is an important area of modern medicine due to the frequent surgical intervention on the organs of the neck. It is known that the innervation of the larynx is provided by the superior and recurrent (inferior) laryngeal nerves. The laryngeal nerves, as well as their branches, can form many anastomoses between themselves inside the organ, which should be taken into account by practicing surgeons to prevent the development of postoperative complications. So, there are a large number of different variants for the innervation of the muscles and mucous membrane of the larynx due to the presence of intralaryngeal anastomoses. As for extralaryngeal anastomoses, they are rare and are of great interest to both morphologists and practicing surgeons. During surgical intervention on the thyroid gland during intraoperative identification of the superior and recurrent laryngeal nerves, the presence of extralaryngeal anastomoses between them can make it difficult to identify the nerves and lead to iatrogenic damage to the latter.
This article describes 3 cases of extralaryngeal anastomoses between the nerves of the larynx established during the macroscopic preparation of organocomplexes of the neck of an adult. The 1st case is an anastomosis between the internal and external branches of the superior laryngeal nerve, the 2nd and 3rd are anastomoses between the external branch of the superior laryngeal nerve and the recurrent laryngeal nerve.

Despite the successes of modern surgery, the achievements of asepsis and antisepsis, the rather wide possibilities of antibacterial, infusion and detoxification therapy, the incidence of peritonitis and mortality from it remain at a high level. The aim of the study was to elucidate the significance of the activity of liver arginase and Kupffer cells in the regulation of total cholesterol in the liver and blood lipoproteins, the level of iodine-containing thyroid hormones and body temperature in rats with experimental peritonitis.
It has been established that under conditions of experimental peritonitis in rats, the activity of liver arginase decreases, the content of NO₃^–/NO₂^– increases and the level of iodine-containing thyroid hormones in the blood decreases, secondary atherogenic dyslipoproteinemia develops. A decrease in the activity of Kupffer cells in peritonitis is accompanied by an increase in the level of triiodothyronine in the blood, a less pronounced decrease in the activity of liver arginase and a weakening of the development of characteristic changes in the content of total cholesterol in the liver, lipoprotein cholesterol in the blood and prevents the development of secondary dyslipoproteinemia. Depression of liver arginase in conditions of peritonitis aggravates changes in the content of total cholesterol in blood and liver lipoproteins, triiodothyronine in the blood and contributes to the development of secondary dyslipoproteinemia.

Autism Spectrum Disorders (ASDs) are developmental disorders that can cause a wide range of problems in social interaction, communication, and behavior. The high prevalence of these disorders worldwide, “masking”, the complexity of diagnosis, the ambiguity of the causes of these developmental disorders, the lack of the possibility of providing effective medical care, the growth of disability in the child population necessitate their comprehensive and timely assessment.
The aim of the work is to discuss the need to develop effective screening methods for identifying autism spectrum disorders, implementing programs to help children with this pathology and their parents, which is the basis for effective rehabilitation and improving the prognosis of socialization in these nosologies. The authors describe 1 clinical case of a patient with an autism spectrum disorder, demonstrating the exceptional importance of an integrative assessment of these disorders in child psychiatry.