Serological tests for the detection of specific antibodies to SARS-CoV-2 are an important tool both for confirming the diagnosis and for the epidemiological investigations. Comparative analysis of ELISA test kits for qualitative determination (yes/no) of IgG antibodies to SARS-CoV-2   available for purchase in the Republic of Belarus was done. The study included four commercial kits of various manufacturers: Vector-Best, Russia; N. F. Gamalei Research Center, Russia; Algimed, Belarus; Wuhan Fine Biotech, China. All test kits showed high quality in detection of specific IgG. The kits produced by Vector-Best, Russia, and Wuhan Fine Biotech, China had the highest sensitivity (100.0 %); the kits produced by Algimed, Belarus, had the greatest specificity (100.0 %). The dependence between the optical density of the samples and the concentration of IgG to SARS-CoV-2 was evaluated. The results showed that it is not possible to make a conclusion about the amount of antibodies based on the optical density of the sample in the test kits designed for their qualitative determination.

Jaundice, caused by a primary violation of the excretion of conjugated bilirubin, occupy a separate place in the structure of jaundice of the newborn. Obstructive jaundice is accompanied by the development of mechanical obstruction of the bile-ducts, which is clinically manifested by yellowish pigmentation of the skin and sclera. Neonatal hepatitis is the main cause of neonatal jaundice with a predominance of direct hyperbilirubinemia. It is resulted in atresia of the extra-hepatic or intrahepatic biliary tract. However, the hereditary nature of the disease cannot be ruled out. Neonatal jaundice workup is a very difficult task and requires non-routine laboratory and instrumental studies, such as abdominal ultrasound with duplex scanning and spectral Doppler ultrasonography, magnetic resonance imaging, liver elastography, percutaneous punctureliver biopsy. Consultation of a geneticist, hepatologist and surgeon is required. The treatment strategy of such severe neonatal pathology need complex, multidisciplinary approach and should be carried out only in highly specialized medical centers. The authors have analyzed the 3 clinical cases of neonatal cholestasis of various nature.

Acute and chronic otitis media remain the leading causes of conductive hearing loss. Every second child by the age of 3 years and by the age of 5 years up to 70 % of children had acute otitis media. Chronic otitis media with effusion is detected during mass examinations of children aged from 2 to 7 years in 30.2 % of cases. The starting point in the development of otitis media with effusion both acute and chronic forms is a violation of the ventilation and drainage functions of the auditory tube. Elimination of effusion from the tympanic cavity after nasopharynx therapy and rehabilitation of the function of the auditory tube occurs in 75 % of cases. Tympanostomy is indicated where the function of the auditory tube is not restored after adenotomy or conservative treatment. Tympanostomy is widely introduced as a method of surgical treatment for otitis media with effusion both acute and chronic forms in a number of countries. However, there is no consensus on the method of intervention and further management of patients among specialists. The article provides an overview of the opinions and results of tympanostomy using in case of otitis media with effusion in children.

Many genetic disorders are found in the prenatal period. The ability to detect them has increased significantly as molecular genetic testing methods have been improved and introduced into clinical practice. Indications for prenatal genetic testing vary widely, and include abnormalities found on ultrasound or aneuploidy screening, family anamnesis of genetic disorders in the parents, advanced age of the mother and/or father. Interpretation of genetic variants identified in the prenatal period presents a unique challenge due to the need to make important decisions regarding pregnancy continuation and perinatal management. This review analyzes the methods that are used for genetic testing, including preimplantation genetic testing of embryos, cell-free DNA testing, as well as diagnostic procedures such as chorionic villus sampling, amniocentesis or percutaneous umbilical cord blood sampling, which provide samples for a wide range of genetic tests. The analysis of the advantages and disadvantages of various fetus genetic diagnostic methods, as well as strategies for their optimal use during perinatal care, was carried out.

Burns in children are a significant pathology, despite strict measures and informing parents on the observance of safety rules in everyday life. Currently, the frequency of burns in children’s institutions kindergartens, schools and other places is minimized. But burns are often found in domestic conditions. According the date of different authors, burns are a global problem. Our purpose of the study was to analyze of literature and identify modern tendency in the management of childhood burns. According the analysis, the treatment of burns in children has undergone evolutionary changes from traditional methods (surgical treatment of wounds, local treatment of burn wounds using ointments and various wound dressings, necrectomy with immediate or delayed autodermoplasty) till to the use of mesenchymal stem cells of burn origin.

A toxicological and hygienic assessment of the pharmaceutical substance of metformin hydrochloride was performed using various regimens, doses and ways of entry into the body of laboratory animals. The conducted studies allowed us to establish the parameters of the toxicometry of metformin and the features of its biological action, which consist in the absence of an irritating effect on the skin and skin-resorptive properties, an allergenic effect on the body and weak cumulative properties and irritant effect on the mucous membranes of the eyes. Hazard classes of the metformin hydrochloride and hygienic regulations for this substance content in the air of the working area and atmosphere have been developed.

The article presents the results of a study of the prevalence of tobacco smoking and the degree of tobacco dependence among cadets of the Academy of the Ministry of Internal Affairs. The purpose of the study is to examine the prevalence of tobacco smoking, assess and compare the level of tobacco dependence among cadets of the investigative-expert and criminal-executive faculties of the Academy of the Ministry of Internal Affairs in 2011 and 2022. To achieve the goal, we carried out an anonymous survey of cadets of the Academy of the Ministry of Internal Affairs, a comparative analysis of the presence and structure of tobacco dependence among cadets of the Academy of the Ministry of Internal Affairs of 2011 and 2022. As a result of the research we established a significant decrease in the prevalence of tobacco smoking among cadets of the Academy of the Ministry of Internal Affairs in 2022 compared to 2011, identified a steady trend towards a decrease in the number of smokers and the degree of dependence on tobacco among students at senior courses in 2022 which indicates the effectiveness of measures to prevent tobacco smoking and promote a healthy lifestyle taken within the walls of the Academy of the Ministry of Internal Affairs.

The number of reported cases of transmission of hepatitis E virus (HEV) through blood transfusion is constantly increasing, making it necessary to screen donations for HEV. The aim of this study was to identify markers of hepatitis E-immunoglobulins G and M, in the blood of Belarusian donors. The material for the study was blood serum samples obtained from 452 donors who donated blood in Minsk in the period from 2020 to 2022. IgM and IgG against HEV in blood serum were determined by enzyme immunoassay using diagnostic kits manufactured by NPO Diagnostic Systems and Vector-Best (RF). Anti-HEV IgG was found in 5.75 % of the samples, and anti-HEV IgM contained 1.77 % of the studied sera. In the ALT group   of positive donors, anti-HEV IgG were detected in 6.8 % of cases and 2.27 % of sera contained anti-HEV IgM. There were no statistically significant differences in the seroprevalence of anti-HEI IgG and anti-HEI IgM depending on sex. Screening for HEV should be introduced into the system of infectious safety of donor blood in the Republic of Belarus. Immunocompromised patients and pregnant women should receive only HEV-negative donated blood products.

This article presents the results of testing methods for detecting bacteria of the Staphylococcus aureus species in the air environment of healthcare facilities in a model experiment in a closed laminar flow hood using typical strains of microorganisms and isolates isolated during air monitoring. The tests were carried out in the microbiology laboratory of Republican unitary enterprise “Scientific practical centre of hygiene” in the 1st quarter of 2021 – the 2nd quarter of 2021. It has been established that the optimal volume of air taken to monitor compliance with the hygienic standard for Staphylococcus aureus in 1 m³ is 500 dm³ per 2 cups. This amount of sampled air will allow the counting of colonies, taking into account their morphology.

The publication is devoted to the issues of acute poisoning in children. We analyzed 61 cases of poisoning in children hospitalized with diagnoses of “Poisoning with drugs, medicines and biological substances” (codes T36-T50), “Toxic effect of substances, mainly non-medical purposes” (codes T51-T65). The mechanisms of poisoning, the clinical picture, ongoing diagnostics and treatment were studied. We found that the highest frequency of poisoning occurred in children under the age of 7 years (67 %). In the age group 1–3 years (43 %), drug poisoning prevailed (43 % of cases). In 73 % of cases, the cause of poisoning in adolescents (13 years and older) was the use of alcoholic beverages. More preventinve conversations should be organized with adolescents with the involvement of psychologists in order to reduce the number of cases of parasuicide. The data obtained in this study on the age structure and causes of poisoning in children will make it possible to carry out their more effective prevention. 

Quantitative methods of morphology are more objective and accurate than qualitative methods, since they are based not only on the instrumental assessment of the trait, but also on the data of the recording equipment, which completely eliminates the subjectivity of the researcher. A morphometric analysis of the lungs of embryos of white rats 18–21 days old, newborns and rat pups 2–10 days of life in normal and experimental oligohydramnios was carried out, a regression model was constructed for the dependence of the relative volume of the respiratory section of the lungs of fetuses, newborns and rats of the first days of life on age. Formulas have been obtained for the norm and experimental oligohydramnios, which make it possible to determine not only deviations in the development of the lungs from normal values during various experimental effects, but also to predict further changes in the respiratory section in normal and pathological conditions. A morphometric study of the autopsy material of the abdominal aorta wall was carried out in 72 people (42 males and 30 females) aged from 1 to 70 years; a regression model was constructed for the dependence of the number of fenestrated elastic membranes on age. Formulas for men and women were obtained, which allow to determine the average number of fenestrated elastic membranes in the middle shell of the abdominal aortain different age periods. The search for correlations in medical morphological studies is especially relevant, as it makes it possible to identify the relationship between different variants of the structure and changes in function.

The purpose of the study is to study the effect of varicose veins of the lower extremities (VVLE) on the quality of life (QoL) and individual hemodynamic characteristics of outpatients with arterial hypertension (AH). The object of the study were outpatients from a number of polyclinics in Minsk with AH of 1 and 2 degrees and in combination with VVLE with chronic venous insufficiency (CVI) of 0–1 degree. QoL was studied using the Russian-language general RAND-36 questionnaire; hemodynamic phenotypes were assessed by BP parameters using the method for analyzing quantitative relationships of BP parameters (AQRBPP). In the course of the study, it was found that AH of 1–2 degrees negatively affects all spheres of life of patients, moderately reducing QOL indicators on all scales of the RAND-36 questionnaire. LEVV with minimal CVI significantly reduces such QoL indicators as SF (social functioning), BP (bodily pain) and HH (compared to the previous year), which requires appropriate correction. At the same time, VVLE with CVI grade 0–1 does not significantly affect the distribution of hemodynamic phenotypes in patients with AH. The study showed that the use of a set of indicators, including, along with traditional methods of research, the determination of QoL and the functional state of blood circulation according to AQRBPP allows you to better objectify the condition of patients with isolated hypertension and in combination with VVLE, conduct dynamic monitoring on an outpatient basis, individualize and optimize the process of treating these patients.

Aim of the study. To compare the effectiveness of distal extension-shortening osteotomy (DESO) of the metatarsals and Weil-osteotomy in the surgical treatment of the middle hammer toe deformity and central metatarsalgia. Treatment outcomes were studied in 80 patients (75 women and 5 men) aged 31 to 79 years (median – 57 [52; 64] years) on 90 feet. The patients were divided into 2 groups: the study group – 32 people, where the DESO was used, and the comparison group – 48 people, in which a typical Weil-osteotomy was performed. Long-term results were studied within 6 to 46 months (median – 24 [10; 33] months). During the examination, a variant of hammertoe deformity was determined, radiometric parameters of the forefoot were measured, the Visual Analogue Scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society Lesser Toe Scale (AOFAS–II–V) were used. After surgery in the study group, the median VAS decreased to 1 [0; 1] points (p < 0,001), in the comparison group – up to 2 [0; 3] points (p < 0,001). Median AOFAS–II–V in the study group increased by 2,2 times and reached 93 [90; 95] points (p < 0,001), in the comparison group it increased only to 85 [73; 90] points (p < 0,001). The received data indicate a higher efficiency of DEMO for hammer toe deformity and central metatarsalgia compared to the standard Weil-osteotomy. The DEMO technique provides a pronounced reduction in pain syndrome (by 6 times), creates conditions for easy elimination of hammer toe deformity, improves the functional state of the forefoot by more than 2,2 times (according to AOFAS–II–V) and obtains positive treatment outcomes in 94,4 % of cases.

Prevention of medical abortion is the most important component of the set of tasks for protecting women's reproductive health. Of the 210 million pregnancies that occur annually in the world, 56 million end in medical abortion [5]. Teenage girls account for up to 10 %, with the majority of abortions being performed by curettage of the uterine cavity [4]. In our country, the problem of abortion is especially relevant, because according to statistics in the Republic of Belarus, there are about 26,6 abortions for every 100 pregnancies, in the world ranking Belarus ranks 5th in the number of abortions [1]. Artificial termination of an unwanted pregnancy often leads to serious, sometimes irreversible consequences for adolescent girls, such as infertility, miscarriage, menstrual irregularities, and inflammatory diseases of the female genital organs. It has been proven that children from mothers with a history of artificial termination of pregnancy are more often born in a state of asphyxia, with impaired cerebral circulation and other pathologies, which leads to an increase in child morbidity and mortality [4]. Especially high is the frequency of complications (55,8 %) after the termination of the first pregnancy in young women. In addition, complications of medical abortion in the structure of maternal morbidity and mortality reach 15–30 %. The economic damage from abortions and related gynecological pathologies annually amounts to 24 trillion rubles. white rubles [1, 5].

The article presents a comparative analysis of laboratory results of total knee arthroplasty and postoperative blood loss in 120 patients (24 men and 96 women) suffering from gonarthrosis, aged 42 to 86 years (average 68.8 years), operated on with the introduction of tranexamic acid periarticularly (n = 60) or without it (n = 60) observed for 3 days. from the time of surgery. Periarticular injection of tranexamic acid (TXA) made it possible to reduce postoperative blood loss. Assessing the data obtained, we determined a significantly lower proportion of cases in the main group (Hb = 118.3) compared to the control group (Hb = 103.3) (P < 0.05). In addition, it was not possible to identify a significant difference in relation to comorbidities or other side effects caused by tranexamic acid.

The most common cause of vertigo is benign paroxysmal positional vertigo (BPPV), which accounts for 17 to 35 % of all peripheral vestibular disorders. The main reason for the development of BPPV is otolithiasis, more often in the posterior semicircular canal. Of the 514 complaints of BPPV, 63.3 % went to the otorhinolaryngologist. Among the patients, women predominated (77.2 %). The structure of the disease was dominated by the lesion of the posterior semicircular canal (82.4 %). According to the survey data, only 21.3 % of otorhinolaryngologists performed diagnostic and therapeutic position tests and maneuvers in patients with recurrent systemic vertigo. Additional methods of examination of patients with BPPV were referred to by 31.3 % of doctors. Another specialist (neurologist, otoneurologist) was referred by 32.2 % of otrinolaryngologists.

Ectopic pregnancy is still actual problem in gynecology nowadays due to its unpredictability and is serious threat for women’s life because in the case of interrupt it’s accompanied massive bleeding. Without contemporary treatment the death is potential. Nowadays there is no common treatment approach for patients with ectopic pregnancy. According to the literature frequency of treatment tactic is dependent of country. The purpose of the work is to assess the validity of the choice of the type of surgery for patients with ectopic pregnancy. The article presents the results of clinical observation of patients with a confirmed diagnosis of tubal pregnancy. The study included 103 case histories of patients whose age corresponded to the reproductive age period, according to WHO criteria (15–49 years) and ranged from 23 to 42 years. Based on the volume of surgical intervention, 5 observation groups were formed. The gynecological anamnesis, complaints of patients when contacting the emergency department, laboratory and instrumental diagnostics performed in dynamics, the choice of treatment tactics (organ-preserving or radical surgery) were analyzed. Based on the data obtained, recommendations for the treatment and follow-up of patients with tubal pregnancy were formed.

Traumatic injuries with the presence of a wound channel and a foreign body are severe injuries, often leading to significant damage to organs and tissues. Timely wound revision in these situations, in combination with foreign body eradication, directly determines good results in further wound healing. The presence of fragments and foreign bodies in the wound canal necessitates their extraction with minimal tissue trauma due to the close location of vascular and neural structures, which means an increased risk of iatrogenic damage, while the known surgical instruments do not allow   this to be achieved duly. Aim. Development of instruments applicable for the revision of wounds with a foreign body in the wound channel, as well as with its subsequent extraction, used in various types of access and various anatomical areas. Materials and methods. Using the method of digital modeling, prototypes of instruments were designed and subsequently manufactured. Experimental testing of the developed tools has been carried out. The material for the study was cadaveric material provided by the Department of Normal Anatomy of the Belarusian State Medical University. Results. The instrument for revision of traumatic wounds of the maxillofacial region and extraction of foreign bodies from them and the surgical hook for revision of traumatic wounds have been developed. Both devices are convenient in operation, while the harpoon-like shape of the working part of the instruments allows you to successfully extract a foreign body from the wound channel with minimal deformation during manipulation, reduce the penetration force, which reduces the trauma of the instrument passing through the tissues, which ensures the integrity of nearby structures and fast wound healing. Conclusion. The developed instruments are effective in the revision of traumatic wounds and the extraction of bone fragments and foreign bodies from them.

Congenital chloride diarrhea (CCD, congenital chloridorrhea and syndrome Darrow-Gamble) is variant of a severe syndrome of electrolyte malabsorption transmitted by autosomal recessive inheritance and manifested by profuse watery stool with massive loss of chlorides and dehydration. Newborn children with CCD need adequate replacement treatment from the first hours of life to prevent electrolyte disorders and dehydration. However, CCD cases, when newborn babies survived even without therapy, were described. But further growth delay, retardation of psychomotor development, nephropathy and hyperaldosteronism was observed as a result of hypochloremia, hypokalemia and metabolic alkalosis. The article describes a pathogenesis, clinical picture, diagnostic criteria, symptomatic therapy and results of our own observation of patient with CCD.

Nephronophthisis is an autosomal recessive cystic kidney disease, which is the most common among cystic kidney diseases of genetic origin the cause of end-stage chronic renal failure and death before the age of thirty years. The article widely presents an interesting clinical case of non-invasive diagnosis of nephronophthisis in a fifteen-year-old child. The diagnosis based on anamnesis, clinical data, and results of laboratory, instrumental and molecular-genetic methods of examination. Ultrasound revealed diffuse changes in the parenchyma, cysts of both kidneys, a decrease in the intensity of blood flow in the parenchyma of both kidneys. The main method that made it possible to confirm NF was molecular genetic, which is less invasive compared to kidney tissue biopsy, which is preferable for pediatric patients.

The article presents up-to-date data concerning etiopathogenesis, clinical manifestations and diagnosis of chronic non-bacterial osteomyelitis in children. Chronic relapsing multifocal osteomyelitis (CRMO) is a rare condition with unknown etiology, which is characterized by presence of numerous relapsing focuses of bone destruction. Diagnostic work-up for CRMO includes magnetic resonance imaging (MRI) and bone scintigraphy, blood culture and bone biopsy. The diagnosis of CRMO can be made if negative results of blood culture and bone biopsy material are observed and bone malignancy and infection are ruled out. Main therapeutic approaches and follow-up are given in the article. Clinical case of CRMO in combination with juvenile idiopathic arthritis (JIA) in a ten year old boy is described. CRMO should be considered and differential diagnosis should be done in cases of atypical course of JIA especially in those with absence of specific immunological markers.

Endocardial fibroelastosis (EF) is one of the rare and under-studied problems of pediatric cardiology. Despite the fact that the disease was described almost 80 years ago, the problem of EF remains unresolved in pediatrics. This is due to the insufficient study of etiopathogenesis, the complexity of prenatal and neonatal diagnostics. Since the mid-twentieth century and until recently, the main cause of EF was considered to be transplacental viral infections caused early congenital carditis, and in a result of which development of cardiomyopathy with a predominance of fibrosclerotic processes. Currently, a certain role in the genesis of EF is given to genetic factors. Thus, EF can be considered as a cardiomyopathy, the cause of which is any cardiac stress. In this article, the authors discribe the issues of epidemiology and etiology of the disease, modern methods of diagnosis, including antenatal diagnostics, and also present a clinical case report of EF in a newborn.

Purpose. Analysis of the most probable causes of infection with the hepatitis C virus (HCV), obtained on the basis of epidemiological history of patients. Materials and methods. We examined 91 patients suffering from various forms of HCV infection, in whom, when collecting an epidemiological history, the emphasis was on the use of injectable psychoactive substances, the presence of blood transfusions, surgical interventions, invasive medical and diagnostic procedures, hemodialysis, transplantation of internal organs or bone marrow, tattooing, piercing , manicure in places of deprivation is free, at home, other institutions   using potentially non-sterile instruments, contact with the blood of a patient with confirmed viral hepatitis C, unprotected sex. Results. The most common combinations are surgery with blood transfusion, paramedical procedures, surgical interventions or invasive diagnostic interventions. Conclusion. Currently, paramedical manipulations are the dominant factors.

A modern obstetrician-gynecologist often faces the problem of correcting the negative changes that occur in the female body in the perimenopausal period. According to the WHO, by 2025 the number of women over the age of 60 will reach 1 billion, which undoubtedly makes the topic of menopausal syndrome therapy discussed by the authors of the article relevant. Since 2020,   the global community has been living in a pandemic caused by the novel coronavirus SARS-CoV-2. And this undoubtedly affects the tactics of treating patients with other pathologies when this infection is attached. A certain alertness is caused by the influence of menopausal hormonal therapy on the hemostasis system. The new coronavirus infection (COVID-19) also activates a wide range of pathological links, affecting many body systems, including the hemostasis system. The authors reviewed a modern approach to the correction of menopausal changes in women using menopausal hormone therapy, the main indications and contraindications for its appointment, including in the context of the COVID-19 pandemic, based on the recommendations of international communities on menopause.