Background: the process of studying at a medical university is associated with emotional stress, which can lead to stress and anxiety.

Aim: to study the range of medications used by medical students for anxiety and (or) stress and the factors influencing their choice.

Material and methods: survey of 106 students of the Medical University (GrSMU) of both sexes (74.5 % female and 25.5 % male) aged 17 to 25 years.

Results: when feeling anxious or stressed, most students use herbal sedatives, for example, valerian tincture, etc. (51 %). The second most popular are glycine (39 %) and phenibut (33 %). Adaptol (mebicar) and Magne B6 are also very popular (26 % each, respectively). In addition, Afobazole (fabomotizole) (14 %), the homeopathic drug Tenoten (10 %) and (less than 3 % of respondents each): Dapten (mebicar), Noofen (phenibut), paroxetine, Grandaxin (tofisopam), chamomile herbal tea.

Conclusions: The vast majority of students do not use medications to reduce anxiety, which may indicate that the level of stress and anxiety in most students is low. Due to easier access to treatment, students prefer over-the-counter medications.

Nobody is not insured from the most common proctological diseases. It is generally accepted that about 50 % of the population of developed countries complains of hemorrhoidal disease. This is especially true during pregnancy and the postpartum period. Hemorrhoids are one of the most common proctological problems in women during these periods. There is evidence in foreign literature that about 25–35 % of pregnant women suffer from symptomatic hemorrhoidal disease in one form or another. Russian authors provide data that clinically significant hemorrhoids occur in 50–65 % of postpartum women. The main treatment for symptomatic hemorrhoids in a pregnant woman is conservative therapy, and surgical treatment is performed only in exceptional cases when there is severe thrombosis of hemorrhoids with significant pain or massive and recurrent bleeding. Surgery carries various risks. This includes an increase in the incidence of postoperative bleeding, an increase in probability of premature birth and the development of persistent non-healing wound with pain, which reduces woman’s quality of life [8]. Issues of pharmacotherapy for hemorrhoids in pregnant and lactating women come down to issues of assessing the safety of drugs, primarily for the child. The risk of adverse effects may depend up the period of gestation. It is traditionally considered that prescription of medications is relatively safety from the second trimester of pregnancy, when the blood-placental barrier is formed. The article discusses cause factors of development of hemorrhoids during pregnancy, its classification, features of the clinical course of the disease, as well as issues of diagnosis and treatment tactics. The principles of disease prevention during pregnancy and the postpartum period are given.

According to the World Health Organization, about 70–85 % of all cases of infectious diseases in the world are acute respiratory viral infections. The widespread of acute respiratory infections, including the influenza virus and COVID-19, requires the search for new methods of prevention and treatment. At the same time, there is significant economic damage due to the high level of morbidity and temporary disability. Infectious diseases most often arise as a result of inadequate functioning of the immune system. It is well known that deficiency of certain microelements, including zinc, is one of the widespread causes of dysfunction of the immune system. Zinc is needed for the normal functioning of the thymus, the main organ of the immune system that produces T-lymphocytes necessary for the destruction of microorganisms and viruses. Consequently, with zinc deficiency, immune defense is weakened.

The purpose of the review article is to analyze the role of Zn in various infectious diseases and the possibility of using dietary supplements containing this microelement to improve the functioning of the immune system and prevent infectious diseases. By analyzing literature data, it was established that the use of Zn plays an important role in the prevention and treatment of infectious diseases through the immunomodulatory, anti-inflammatory, antioxidant and antiviral properties of this microelement.

The article provides a brief overview of the main information on the negative impact on the environment and human health of non-renewable natural energy resources currently used in the world – oil, coal, gas, oil shale, peat, uranium. A brief general description of the relevant sources of industrial energy, the world reserves of these energy resources, their production volumes, and distribution across different countries is given. It is noted that there is a need to change the structure of the global energy balance and search for fundamentally new approaches to the development of environmentally safe and highly efficient energy sources to fully meet all the needs of mankind.

The article provides current data on the applied anatomy of the Lisfranc joint, mechanisms of injury, classification, diagnostics and treatment. Lisfranc joint injuries are relatively rare – just 0,2 % of all fractures. They include wide spectrum of injuries: from ligament tears to complex fracture-dislocations with severe concomitant soft-tissue injuries. Up to one third of injuries are missed during initial examination. When properly not diagnosed and not treated early these injuries may lead to severe disability. Initial radiological diagnostics shall include three standard projections: AP, lateral and AP with foot pronation. CT (especially 3D-reconstructions) play important role in the pre-operative planning, and in the diagnostics of the injuries with only mild displacements. During initial treatment it is important to reduce grobe displacements of the forefoot, which may lead to compartmentsyndrome or disorders of the blood supply of the distal part of foot. Closed reduction and wire fixation is appropriate only as initial emergent treatment. The mainstay of the definitive fixation is the open reduction and solid fixation (with screws and/or plates) which enables the restoration of the middle foot stability.

This paper presents the view of mental health professionals on the problems that exist in the implementation of their constitutional rights by victims with psychiatric/psychological injury.

Purpose of the work: to analyze the regulatory, legal and practical factors that prevent victims with mental trauma from effectively realizing the protection of their rights and legitimate interests in criminal proceedings, as well as to develop possible options for overcoming the obstacles in the process of realizing their legitimate interests by victims with psychiatric/psychological injury.

Results. In accordance with domestic legislation, compensation for mental suffering by a court decision is allowed only upon the request made by the victim. If such a requirement is not stated, then the court itself does not have the right to decide the issue of compensation. In turn, there are a number of reasons that prevent people with mental trauma from independently seeking compensation for mental suffering, among which a purely medical factor stands out. For example, individual symptoms of anxiety, depression, phobia and posttraumatic stress disorder (avoidance of situations reminiscent of the circumstances of the injury) lead to the fact that victims in every possible way avoid any events related to proving the trauma they suffered, much less a detailed trial.

Conclusions. Regulatory, legal and practical problems that prevent victims with psychiatric/psychological injury from effectively implementing the protection of their rights and legitimate interests can be quite successfully overcome with the help of joint efforts of lawyers and mental health professionals. One of the first significant steps may be the emergence of a legislative mechanism for the mandatory involvement of a victim representative (lawyer) for victims of violent crimes (crimes against life and health).

At a time when there is the rapid and active movement of dental prosthetics supported by dental implants, one of the significant disadvantages is the need for additional visits, repeated manipulations and a substantial overall duration of treatment. Existing ways to reduce the number of visits and overall duration of treatment are covered in modern literature, supported by scientific explanation of the indications for the choice of treatment methods. One option is to install an implant into the dental alveolus immediately after tooth extraction. The purpose of the work was to analyze modern trends in the treatment of complete or partially edentulous patients using the method of immediate dental implant placement. Based on the results of the analysis, it was established that up to now the precise criteria for the possibility of immediate dental implant placement with immediate loading after the removal of teeth with odontogenic foci of chronic infection have not been developed, as well as methods of surgical treatment of alveolar socket for immediate dental implant placement have not been developed or scientifically grounded.

Compulsive overeating (CO) is a type of eating disorder that often leads to obesity (in 40–70 % of cases). CO includes 3 key, but not mutually exclusive, components: (1) habitual overeating, (2) overeating to alleviate negative emotional states, and (3) overeating despite adverse consequences [3]. The principles of the most effective treatment for this type of eating disorder remain unknown today. According to literature reviews, lifestyle changes, psychotherapy, pharmacotherapy, and bariatric surgery are the most commonly used treatments of compulsive overeating [4]. Purpose of the work: to analyze data from literary sources addressing the issues of treatment of compulsive overeating; highlight the advantages of a multidisciplinary approach in accompanying persons with this deviant eating behavior.

The article presents the results of a study of the health status of employees of a pharmaceutical enterprise by the method of prescriptive-immunological analysis of the results of the survey. The purpose of this study was to identify the features of the formation of health disorders, their nature and prevalence among workers involved in the production of medicines.

Materials and methods. The study was conducted with the participation of 36 employees of the drug tableting and packaging shop, 33 employees of the shop for the production of antitumor drugs in the form of freeze-dried powders and solutions for injection, 51 employees of the shop for the production of liquid medicines, 70 employees of plant management departments (comparison group). The survey of all study participants was conducted after obtaining their written informed consent.

Conclusion. Unfavorable working conditions for workers involved in the production of drugs have a negative impact on their health, causing a high prevalence of manifestations of health disorders, mainly from the skin and the respiratory system, which are mainly allergic in nature, as evidenced by 7.5–7.8 – multiple excess (p < 0.05) of the frequency of allergic syndromes in workers of production shops in relation to the comparison group.

The article presents an analysis of the surgical treatment of 244 male patients which underwent surgery for an inguinal hernia: 96 patients underwent Lichtenstein technique surgery, 118 patients underwent TEP (total extraperitoneal hernioplasty), 30 patients underwent hernioplasty using the Desard technique. Patients were divided into two groups depending on age. The presence of concomitant pathology in patients, the duration of surgical treatment, the need for analgesics and postoperative complications were analyzed. Indications for each of the hernioplasty techniques were determined depending on the age, presence or absence of cardiovascular pathology and diabetes mellitus. All proposed techniques are reliable towards disease relapse. Operation Desarda has all the advantages of operations performed under local anesthesia. It can be performed in old age, is short in time, does not require narcotic analgesics, and allows you to quickly mobilize the patient.

The current scientific and practical interest in magnesium-based implants is largely related to its biodegradability and ability to improve healing and bone formation. Metal ions promote the process of osteogenesis and osseointegration of the implant with surrounding tissues. The creation of biodegradable structures does not require revision operations. Biodegradable metal materials are new and promising materials for the manufacture of medical products that tend to completely dissolve in the body. The combination of different alloying elements in alloys and different processing conditions has led to the emergence of a wide variety of materials with controlled mechanical properties and corrosion rates. Magnesium alloys meet safety standards for practical use in orthopedics and traumatology.

The article presents the results of a study of occupational morbidity among workers in the Zavodsky district of Minsk for 2004–2021. The purpose of this study was to assess the effectiveness of measures to prevent the adverse effects of production factors on the health of workers.

Materials and methods. The research materials were reports of chronic occupational diseases of workers in the Zavodsky district of Minsk and information materials from the occupational hygiene department of the Center for Hygiene and Epidemiology in the Zavodsky district of Minsk. Methods: epidemiological, sanitary description.

Conclusion. The dynamics and structure of occupational morbidity quite clearly reflected the preventive measures taken: since 2010, there has been a sharp decrease in the levels of occupational morbidity, mainly due to a decrease in the number of cases of occupational diseases caused by exposure to physical factors (noise, vibration). In the future, it is necessary to develop areas of preventive measures aimed at dust and aerosols in the air of the work area to reduce occupational pathology of the respiratory system.

With the increasing role of digital technologies in all areas of human activity, the use of 3D modeling and 3D printing is constantly growing. Three-dimensional visualization methods are actively being introduced into various fields of medicine: new technologies of 3D modeling and 3D printing are being developed. Most often, this area affects surgical specialties. One of the promising areas for using 3D models in otorhinolaryngology is preoperative planning with determination of the minimum size of a bone defect in the anterior walls of the paranasal sinuses during external access to perform a successful surgical intervention. A computed tomography scan of the patient is used as initial information for calculations. Based on this information, a 3D model of the facial skeleton is created, and at the next stage it is analyzed. The use of spatial and numerical calculation methods, which are based on the data of a specific patient, allows us to take into account the anatomical features of the structure of the patient’s facial skeleton, the individual size and shape of the sinus. In the course of this study, we propose a mathematical algorithm to determine the appropriate localization of a trepanation defect in the anterior wall of the maxillary sinus during extranasalsurgical intervention.

Anemia is one of the most common pathological conditions in children. According to WHO, about 43 % of children in the world are anemic. The most common disease in children is iron deficiency anemia (IDA). In second place is “anemia of chronic diseases” – ACD. Due to the different approaches to the correction of these anemias, the differential diagnosis of IDA from ACD is relevant. According to foreign researchers, reticulocyte indices, in particular the hemoglobin content in reticulocytes, “better” in the differential diagnosis of anemia compared to the generally accepted erythrocyte indices and biochemical tests.

The goal is to assess the diagnostic significance of reticulocyte hemoglobin in the differential diagnosis of anemia of various origins in children, and the relationship of this indicator with generally accepted diagnostic tests.

Material and methods. We examined 118 children aged from 6 months to 18 years who were undergoing treatment and examination for various diseases, of which 53 had IDA, 32 had ACD; 33 – comparison group. The diagnostic significance of the generally accepted hemogram indicators, “issued” by an automatic blood analyzer, was compared, as well as a number of biochemical indicators – serum ferritin (SF), serum iron (SI), transferrin, latent iron binding capacity of serum (LIC), C-reactive protein (CRP), and hemoglobin content in reticulocytes – Ret-He.

As a result of the study, it was possible to establish:

1) hemoglobin content in reticulocytes is a highly sensitive method for detecting iron deficiency (ID), along with the well-known erythrocyte (MCV, MCH, CP, etc.) and biochemical tests (LVSS, SG, transferrin, etc.), except for SF, which shows “false positive” results in the presence of inflammation;

2) the Ret-He study, in combination with standard erythrocytic and biochemical tests, allows not only to differentiate IDA from ACD, but also to identify a group of patients who are contraindicated for ferrotherapy, since their ID is relative, not absolute;

3) in some patients with ACD, a comprehensive examination revealed a combined effect on erythopoiesis and ID, inflammation, and nutritional disorders. Thus, the high diagnostic significance of the determination of reticulocyte hemoglobin and the advisability of including the Ret-He determination for the diagnosis of IDA and differential diagnosis with ACD are confirmed.

Aim/Objective. To assess the feasibility of the individual approach using endovascular embolization (EVE) in patients with postoperative pancreatic fistulas (POPF) and subsequent postoperative bleeding (POB) after longitudinal pancreaticojejunostomy (LPJ) for chronic pancreatitis (CP).

Materials and methods (Case report). After performing LPJ in 33 patients was noted a low number of postoperative complications – 4/12.1 % (95 % CI: 6,2–29,4) cases with no death. We described a case report of severe complication involving POPF type «С» and later POB type «С» from the artery pseudoaneurysm.

Results. At present, there is no unified concept regarding the tactics of surgical treatment of POB in the analyzed available literature sources, that have arisen against the background of resection or resection-drainage surgical interventions for CP. The main factors of its occurrence are: postoperative pancreatitis, POPF, biliary discharge, abscess. There is a significant statistically correlation between the additional presence of bile in the drains and the occurrence of POB. Lysis of the vessel wall or the ligated stump of the artery occurs, in the case of abscess formation, which leads to the occurrence of POB.

Conclusions. It is necessary to develop and implement the algorithm for the diagnosis and treatment POB, that occur after resection and resection-drainage operations on the pancreas. This case report shows the possibility of successful EVE of the right gastroomental artery in pseudoaneurysm (POB «C») associated with pancreatic fistula (POPF «C») after longitudinal pancreaticojejunostomy

The tympanic orifice (Foramen tympanicum or Huschke orifice) is an opening preserved during temporal bone development in the front-lower bony portion of the external auditory canal. Its occurrence in the population ranges from 0.4 % to 20 %. Persistence of the tympanic orifice in children up to 5 years age can be considered a variation of the norm. The tympanic orifice may not manifest for a long time and manifests in adult in the form of herniation of the temporomandibular joint capsule or fistula in the bony part of the external auditory canal and cases of saliva discharge into the external auditory canal have been described which can be interpreted mistakenly by otorhinolaryngologists as external otitis media. The article describes a rare case for otorhinolaryngologists, when «under the masks» of parapharyngitis and otitis the child had abscessed lymphadenitis in the submandibular region on the right side which drained into the external auditory canal through the tympanic orifice. The final diagnosis was established by CT with contrast.

Introduction. The microbial landscape of a pharynx at the period of COVID-19 pandemic, compared to the pre-Covid period, have a great practical and scientific importance.

Purpose. We determine the microbial landscape in patients with pharyngitis during the pandemic of the new coronavirus infection COVID-19 and the dynamics of antibiotic resistance of the most common types of microorganisms in comparison with the “pre-Covid” period.

Materials and methods. We estimated 403 samples of throat culture from patients with pharyngitis. The main group consists of 308 samples from patients during the COVID-19 pandemic (2020–2022 years). The comparison group consists of 95 samples taken in 2019 year.

Results. We reveal the following features of throat culture: Gram-positive flora, mainly S. aureus, decreases by 2 times, and Candida spp. increases by 2 times in patients with pharyngitis during the COVID-19 pandemic, compared with the pre-Covid period, p < 0.05. Kl. pneumonia slightly increases up to 18 % in 2020. Enterococcus spp., on the contrary, had a slow but steady trend towards an increase from 5 % in 2019 to 12 % in 2022 (p > 0.05), which may indicate the development of pharyngeal dysbiosis that occurs during treatment of COVID-19 infection.

Throat culture bacteria increase resistance to semisynthetic penicillins: S. aureus rom 4 % to 12–30 % (p < 0.05), Klebsiella pneumoniae from 33 % in 2019 to 54 % in 2021 (p < 0.05), with a subsequent decrease to 28 % in 2022. Klebsiella pneumoniae also increases resistance to fluoroquinolones from 25 % in 2019 to 40 % in 2021 (p < 0.05).

A high level of morbidity of the population requires the adoption of informed management decisions and the implementation of effective preventive measures aimed at early detection of functional disorders of the body and preventing the development of chronic pathology. In this regard, it is very relevant to analyze the current state and identify trends in the formation of health of the younger generation. In order to assess the health status of children, a retrospective analysis of data from state statistical reporting of the Republic of Belarus and a polyclinic health care institution in one of the administrative districts of Minsk was carried out. It was established that the primary incidence of children 0–17 years old over the course of 5 years of observation has a high level and a moderate upward trend in the near future. According to the results of preventive examinations, he most common health abnormalities in children are decreased visual acuity, scoliosis and impaired posture, for which an increase in prevalence is predicted in the coming years. At the same time, the number of functional disorders and the degree of loss of health increase as children grow up, transition to training in institutions of general secondary education and with the accumulation of school «experience».

Background. Identification and clarification of the role of clinical and laboratory indicators in assessing the unfavorable prognosis of COVID-19 is important, allowing to identify patients at risk at an early stage of the pathological process.

The purpose of this work was to identify clinical and laboratory predictors that influence worsening prognosis and mortality in COVID-19.

Materials and methods. The study was conducted at the 5th City Clinical Hospital in Minsk, which involved 240 patients with severe COVID-19.

Results. According to the results of the study, in the group of the deceased persons of older age group prevailed, the average index of comorbidity of pathologies in the group of the survivors was 2 pathologies (max 7, min 0), in the group of the deceased – 2 pathologies (max 10, min 0, Me 3), which had statistically significant difference at the level of p = 0.00006. Among complications, the most frequently recorded were DN 1–3 degree (in 84.87 % of surviving patients and 71.9 % of deceased patients), pulmonary edema (in 2.52 and 12.4 % of patients, respectively), SPON (in 5.88 and 19.83 % of patients, respectively). A decrease in SrO2 less than 93 % significantly reduced the chances of recovery (OR 0.422; 95 % CI 0.138–0.637). An elevated CRP level > 5 mg/L had a significant association with unfavorable COVID-19 outcome (OR 2.721; 95 % CI 1.342–6.657).

Conclusion: factors affecting prognosis in COVID-19 turned out to be older age, desaturation less than 93 % (χ² = 245.211; p < 0.0001), high percentage of comorbidity p = 0.00006 (p < 0.05), leukocytosis (χ² = 18.36; p < 0.001), increased levels of C-reactive protein (χ² = 132.455; p < 0.001), procalcitonin, IL-6, D-dimers (χ² = 161.122; p < 0.001).

Objective. To analyze the factors causing disability in patients with dysfunction of the pelvic organs caused by spinal canal stenosis, injuries of the thoracic and lumbosacral spine.

Material and methods. The study included 73 patients with dysfunction of the pelvic organs due to spinal stenosis and spinal cord injury of the thoracic and lumbosacral spine. During the study, an assessment was made of the rehabilitation potential and prognosis, categories of impairments, and limitations of life activity in interaction with environmental factors, which made it possible to identify the main criteria for the risk of disability and its severity.

Results. The risk of disability in patients with dysfunction of the pelvic organs is determined by the influence of several factors related both directly to the clinical manifestations of the disease and its consequences, and to the clinical and labor prognosis.

Conclusion. The result of the study was a diagnostic algorithm for determining the presence and severity of dysfunction of the pelvic organs in patients with spinal stenosis, injuries of the thoracic and lumbosacral spine for use in the practice of medical and social examination.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders of menstrual and reproductive functions. The prevalence rate among girls ranges from 2.2 to 7.5 %, among women of reproductive age – 15 %, and among patients with anovulatory infertility – 73 %. The high prevalence of this pathology in the female population (up to 10 %) places it among the relevant medical problems associated with the development of primary infertility, endometrial hyperplastic processes, obesity, and cardiovascular pathology. The formation of PCOS is often associated with puberty. The instability of gonadotropin synthesis, characteristic of this age period, and the physiological increase in the level of androgens and insulin are precursory factors for the occurrence of PCOS. The article is devoted to the study of factors that can influence the development of the reproductive system and lead to the formation of PCOS. The social, family and perinatal history of girls with emerging polycystic ovary syndrome was studied. It is noted that their puberty is often accompanied by a number of deviations: incorrect order of formation of secondary sexual characteristics, early pubarche, early and late thelarche, early and late menarche. Timely detection of such disorders underlies the formation of a risk group for the development of PCOS and the prevention of reproductive disorders in the future.

The article highlights the medical and social patterns of death due to drowning. The purpose of the study is to identify the medical and social characteristics of death as a result of mechanical asphyxia due to the closure of the airways with water during drowning. To achieve this goal, a retrospective analysis of drowning cases in the Zavodsky and Leninsky districts of Minsk for 2021–2023 was carried out by studying 28 reports of forensic medical examinations of corpses conducted on the basis of the general examination department No. 1 of the department of the State Forensic Examinations Committee of the Republic of Belarus in the city of Minsk. Based on the results of the study, a medical and social portrait of a person who died as a result of drowning was created. The identified patterns can be used to update measures to prevent death from this type of mechanical asphyxia.