Journal of Clinical and Biomedical Research
The Journal of Clinical and Biomedical Research (J Clin Biomed Res) is an international, peer-reviewed, open-access journal that publishes high-quality research in clinical medicine, biomedical sciences, and medical education. The journal provides a scholarly platform for medical doctors, medical educators, master’s students, and PhD researchers to share original research, reviews, clinical studies, and educational innovations. J Clin Biomed Res emphasizes evidence-based medicine, translational research, and studies that bridge basic science with clinical practice. With a commitment to ethical publishing, rigorous peer review, and global accessibility, the journal aims to support academic development and contribute to the advancement of modern healthcare and biomedical research.
Journal of Clinical and Biomedical Research (JCBR)
Improving Perinatal Care Strategies to Prevent Preterm Birth and Reduce Reproductive Losses
Background: Preterm birth remains a principal driver of neonatal morbidity and perinatal mortality in Central Asia. Objective: This study evaluated the effectiveness of a structured perinatal care intervention in reducing preterm birth rates and reproductive losses at the Perinatal Center of the Fergana Region compared with a matched cohort from Andijan. Methods: A prospective comparative study enrolled 112 patients in each group over 2022–2024. The intervention comprised antenatal corticosteroid prophylaxis, cervical length screening, progesterone supplementation, and multidisciplinary team-based care. Results: The Fergana cohort demonstrated a preterm birth rate of 6.4% versus 11.8% in Andijan (p < 0.001), with neonatal mortality reduced from 5.7% to 2.1% (p = 0.003). Overall perinatal losses declined by 59.5%. Conclusion: Comprehensive, protocol-driven perinatal care substantially reduces preterm birth incidence and reproductive losses in a regional setting.
Copyright (c) 2026 Journal of Clinical and Biomedical Research
Folk Medicine Practices and Their Implications for Perioperative Safety in Surgical Patients: A Narrative Review
Background: Folk medicine is deeply embedded in the health-seeking behaviour of populations across Central Asia and globally, with herbal remedies frequently used by patients who subsequently undergo surgical procedures. This narrative review examines the intersection of traditional folk medicine and perioperative surgical safety, focusing on the pharmacological risks posed by commonly used herbal substances. Methods: A structured literature search was conducted across PubMed, Scopus, and Google Scholar using relevant MeSH terms spanning 2000–2024. Studies addressing herbal medicine use in surgical populations, wound healing, and preventive medicine were synthesised. Results: Between 30% and 70% of surgical patients use herbal preparations perioperatively, and fewer than 35% disclose this to their surgeon. High-risk agents include garlic, ginkgo biloba, St. John's wort, and valerian, each associated with bleeding, haemodynamic instability, or anaesthetic interactions. Wound healing evidence supports several traditional preparations. Conclusions: Integration of folk medicine history into preoperative assessment is essential. Structured disclosure protocols and preventive education can substantially mitigate surgical risk.
Hip Fracture in Elderly Asian Patients: Epidemiology, Surgical Outcomes, and Strategies for Optimizing Perioperative Management
Background: Hip fracture among the elderly represents a major public health challenge across Asia, where rapid population aging and growing osteoporosis burden are converging to produce alarming incidence rates. Objective: To review the epidemiology of hip fractures in elderly Asian patients, compare surgical treatment approaches, analyze perioperative outcomes, and identify evidence-based strategies for improving management. Methods: A narrative synthesis was conducted integrating published literature from 2019 to 2025. Results: Significant heterogeneity was found across Asian countries in surgical timing, mortality rates, and rehabilitation practices. One-year mortality ranged from 16.5% to 23.1%, while surgery within 48 hours varied from 28.4% to 71.3%. Conclusion: Standardized care pathways, early surgical intervention, and multidisciplinary geriatric co-management represent the most impactful strategies for reducing hip fracture burden in Asia.
Improving Perinatal Care for Prevention of Preterm Birth and Its Effectiveness in Reducing Reproductive Losses: A Comparative Regional Study in Uzbekistan
Preterm birth remains a principal driver of neonatal morbidity and perinatal mortality in Central Asia. This prospective comparative study evaluated the effectiveness of an enhanced perinatal care protocol in reducing preterm birth and associated reproductive losses. A total of 224 pregnant women were enrolled: 112 from the Perinatal Center of the Fergana Region (intervention group) and 112 from the Andijan Regional Perinatal Hospital (control group). The intervention incorporated transvaginal cervical length screening, targeted vaginal progesterone therapy, antenatal corticosteroid administration, and multidisciplinary risk-stratified follow-up. Mean gestational age at delivery was significantly greater in the Fergana group (35.8 ± 2.6 vs. 33.9 ± 3.4 weeks; p<0.001). The preterm birth rate was reduced by 38% (28.6% vs. 46.4%; p=0.004), and perinatal mortality declined by 50% (3.6 vs. 7.1 per 1,000 births; p=0.041). These findings support the broad implementation of evidence-based perinatal protocols across regional obstetric centers to meaningfully reduce preventable reproductive losses.
Hematological Manifestations of Iron Deficiency Anemia in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Analytical Study
Background: Iron deficiency anemia (IDA) represents a prevalent but frequently overlooked comorbidity in type 2 diabetes mellitus (T2DM), potentially distorting glycemic monitoring and accelerating complications. Methods: A cross-sectional study was conducted among 200 participants (72 T2DM with IDA, 78 T2DM without IDA, 50 healthy controls) at Fergana Medical Institute of Public Health. Hematological indices, serum iron parameters, HbA1c, fasting glucose, and inflammatory markers were assessed. Results: T2DM patients with IDA demonstrated significantly elevated HbA1c (9.6 ± 1.7% vs. 8.2 ± 1.3%, p < 0.001), reduced hemoglobin, serum ferritin, and transferrin saturation, alongside markedly impaired renal function and greater diabetes duration. Diabetic nephropathy and peripheral neuropathy were significantly more frequent in the IDA group. Conclusion: IDA independently amplifies glycemic dysregulation in T2DM and correlates with advanced microvascular complications, highlighting the necessity of routine iron screening in diabetic care.
Integrated Perinatal Care Protocols Reduce Preterm Births and Reproductive Losses in Uzbekistan
Background: Preterm birth remains a leading cause of neonatal morbidity and perinatal mortality in Central Asia. Uzbekistan bears a disproportionate burden, with limited evidence guiding regional perinatal protocols. Methods: A prospective comparative study was conducted at the Perinatal Center of the Fergana Region (intervention group, n = 112) and a matched cohort from Andijan Regional Perinatal Center (control group, n = 112). The Fergana group received an integrated care bundle comprising antenatal corticosteroids, magnesium sulfate neuroprotection, evidence-based tocolysis, and structured antenatal surveillance. Primary outcomes included preterm birth rate, perinatal mortality, and NICU admission. Median gestational age and birth weight were compared using the Mann–Whitney U test; proportions were assessed with chi-square analysis. Results: The Fergana intervention group demonstrated significantly lower preterm birth rates (8.9% vs. 14.7%, p = 0.003), perinatal mortality (12.4 vs. 21.8 per 1000, p = 0.001), and NICU admissions (24.1% vs. 38.5%, p < 0.001). Conclusion: Structured, evidence-based perinatal care bundles substantially reduce preterm delivery and reproductive losses in the Fergana region.
Volar Locking Plate Fixation Versus Conservative Management of Distal Radius Fractures: A Two-Centre Comparative Analysis
Distal radius fractures (DRF) are the most frequent upper-limb injuries, yet the optimal treatment for displaced fractures remains debated. This study compared volar locking plate (VLP) fixation with predominantly conservative management across two centres. We retrospectively reviewed 112 patients treated at the private hospital “Primus,” where VLP fixation predominated, and 112 demographically matched patients from the Andijan region, where closed reduction with casting and external fixation prevailed. Functional recovery was assessed with the QuickDASH and Patient-Rated Wrist Evaluation, supplemented by grip strength, radiographic restoration, and complication rates over twelve months. The Primus cohort achieved significantly lower DASH scores at every interval, faster grip-strength recovery, and more accurate radiographic restoration, with a comparable overall complication burden but a different complication profile. Conservative management remained acceptable for low-demand, stable fractures. These findings support an individualised, fracture- and patient-specific algorithm in which surgical fixation offers earlier functional return for displaced, unstable injuries.
Cognitive Impairment Profile in Adolescents with Iron Deficiency Anemia: A Comparative Cross-Sectional Analysis
Iron deficiency anemia (IDA) is a leading nutritional disorder among adolescents globally, with well-documented consequences for brain function and cognitive development. This cross-sectional comparative study investigated characteristics of cognitive impairment in 120 adolescents aged 12-17 years in the Fergana region of Uzbekistan. Sixty adolescents with confirmed IDA were compared with 60 age- and sex-matched healthy controls. Cognitive function was assessed using the Schulte Table Test, Digit Span Task, Stroop Color-Word Test, and Trail Making Test. Adolescents with IDA showed significantly impaired performance across all cognitive domains - sustained attention, working memory, executive function, and processing speed - compared to controls. Anemia severity correlated inversely with cognitive composite scores. Female adolescents were disproportionately affected. These findings highlight the burden of anemia-related cognitive dysfunction in adolescents and support integration of cognitive screening within routine anemia management protocols.
Problem-Based Learning and Digitally Integrated Clinical Education: Transforming Undergraduate Medical Training
Medical education has undergone significant pedagogical transformation over the past two decades. Problem-based learning (PBL) and digitally integrated clinical learning (DICL) have emerged as two of the most influential student-centred approaches reshaping undergraduate medical curricula worldwide. This comprehensive review synthesises evidence from 60 peer-reviewed publications to compare the effectiveness of PBL and DICL against traditional lecture-based learning (LBL), examining outcomes across knowledge acquisition, clinical competence, critical thinking, student satisfaction, and self-directed learning. Findings consistently demonstrate that both PBL and DICL outperform LBL in higher-order cognitive skills and clinical reasoning, while LBL retains a modest advantage in foundational knowledge delivery efficiency. Hybrid models integrating PBL with digital platforms show the most promising synergistic outcomes. Contextual challenges—including resource intensity, faculty readiness, and infrastructure limitations—require institutional consideration. The evidence supports a progressive transition toward integrated, technology-enhanced, problem-centred curricula in medical schools, particularly in developing healthcare education systems.
Three-Dimensional Printing in Orthopedic Trauma Surgery: A Narrative Review of Patient-Specific Approaches Transforming Fracture Care Across Asia
Orthopedic trauma surgery faces persistent challenges in managing complex, intra-articular, and periarticular fractures, where conventional two-dimensional imaging often fails to convey true fracture morphology. Three-dimensional (3D) printing has emerged as a transformative additive-manufacturing technology enabling anatomical models, patient-specific surgical guides, and customized implants. This narrative review synthesizes current evidence on the technical foundations and clinical performance of 3D printing in fracture management, with particular attention to its rapid adoption across the Asia-Pacific region. Evidence from randomized trials and meta-analyses consistently demonstrates reduced operative time, lower intraoperative blood loss, fewer fluoroscopy exposures, improved reduction quality, and comparable or lower complication rates relative to conventional techniques. A comparative analysis of conventional versus 3D-assisted workflows highlights advantages in preoperative planning, intraoperative precision, and surgical education. Despite logistical, regulatory, and cost barriers, 3D printing represents a clinically meaningful advance toward personalized fracture care, and its trajectory suggests increasing integration into routine trauma practice throughout Asia and beyond.
Phytopreparations As Alternatives to Synthetic Drugs: Toxicological Safety and Pharmacoeconomic Efficiency
This study evaluated phytopreparations as potential alternatives to synthetic drugs from the perspectives of toxicological safety and pharmacoeconomic efficiency. Scientific literature related to phytopharmacology, toxicological assessment, and economic effectiveness of herbal medicines was analyzed. The findings demonstrated that phytopreparations possess complex synergistic pharmacological effects and generally demonstrate lower toxicity profiles compared with many synthetic monocomponent drugs. Lower production costs and reduced research expenditures additionally increase their economic attractiveness in healthcare systems. However, variability in active compound concentrations and insufficient standardization remain major limitations affecting therapeutic safety and quality control. The results indicate that scientifically standardized phytopreparations may serve as effective complementary or alternative therapeutic agents in modern pharmaceutical practice.
Preventive Strategies Against Neurological Complications in Endocrine Disorders: A Comprehensive Interdisciplinary Review
Background: Endocrine disorders, including diabetes mellitus, thyroid dysfunction, and adrenal diseases, are major contributors to neurological complications, yet preventive approaches remain poorly integrated across disciplines. Objective: To synthesize current evidence on epidemiology, mechanisms, and prevention of endocrine-related neurological disorders. Methods: A narrative review of studies published between 2017 and 2026 was conducted using PubMed, Embase, Cochrane Library, and Frontiers, focusing on systematic reviews, meta-analyses, randomized trials, and large cohort studies. Results: Neurological complications affect up to 90% of patients with long-standing type 2 diabetes, with peripheral neuropathy most common. Thyroid dysfunction contributes to approximately 10% of potentially reversible dementia cases. Emerging evidence suggests GLP-1 receptor agonists may reduce Alzheimer’s disease risk by up to 70% in diabetic populations. Multifactorial strategies combining glycemic, lipid, blood pressure, and hormonal control reduce neurological morbidity by 30–60%. Conclusion: Integrating neurological risk assessment into endocrine care is essential for effective prevention.
Improving the Prevention of Acute Intestinal Infections Based on the Integration of Molecular Epidemiology and Mathematical Modeling
Acute intestinal infections remain one of the most important public health problems due to their high prevalence, rapid transmission, seasonal outbreaks, and significant social and economic consequences. Traditional epidemiological surveillance methods are often insufficient for early detection of outbreaks, identification of transmission routes, and prediction of epidemic dynamics. In recent years, molecular epidemiology and mathematical modeling have become powerful tools for improving infectious disease control. Molecular epidemiology makes it possible to identify pathogens, determine their genetic characteristics, trace transmission chains, and detect circulating strains. Mathematical modeling allows assessment of outbreak dynamics, estimation of reproduction potential, forecasting of disease spread, and evaluation of preventive interventions. The aim of this study was to assess the importance of integrating molecular epidemiology and mathematical modeling in improving the prevention of acute intestinal infections. The study analyzed clinical, epidemiological, laboratory, and molecular data on acute intestinal infections and evaluated their application in predictive modeling.
Prediction of Complication Risk Based on Biomarkers in Patients with Acute Diarrhea and Chronic Heart Failure
Acute diarrhea is a common clinical syndrome that may cause dehydration, electrolyte imbalance, acute kidney injury and systemic inflammatory response. In patients with chronic heart failure, acute diarrhea has a particularly unfavorable clinical significance because fluid loss, hypovolemia and electrolyte disturbances can provoke heart failure decompensation, arrhythmias, renal dysfunction and cardiorenal complications. The aim of this study was to evaluate the prognostic value of laboratory biomarkers in predicting the risk of complications in patients with acute diarrhea and chronic heart failure. The study included patients with chronic heart failure who developed acute diarrhea. Clinical symptoms, hydration status, hemodynamic parameters and laboratory biomarkers were assessed. Special attention was paid to serum creatinine, estimated glomerular filtration rate, urea, sodium, potassium, C-reactive protein, leukocyte count, hematocrit and albumin levels. The results showed that elevated creatinine, increased urea, reduced estimated glomerular filtration rate, hyponatremia, hypokalemia, elevated C-reactive protein and leukocytosis were associated with a higher risk of complications.
Neurological Complications of Diabetes Mellitus: Endocrinological Mechanisms, Preventive Medicine Strategies, and Prophylactic Interventions
Background: Diabetes mellitus (DM) is a chronic metabolic disorder with rising global prevalence that causes diverse neurological and systemic complications. The overlap between endocrinology and neurology in DM care requires clear understanding of pathophysiology and preventive pharmacological strategies to reduce morbidity and mortality. Objective: This review summarizes neurological complications of DM, including peripheral and autonomic neuropathies, cerebrovascular disease, and other neuro‑endocrine manifestations, and synthesizes current evidence on preventive medicine and prophylaxis. Methods: A narrative review of PubMed, Scopus, and Web of Science (2000–2024) identified fifty peer‑reviewed publications selected for relevance, methodological quality, and recency. Results: Diabetic peripheral neuropathy affects up to 60% of patients with long‑standing DM, while cardiac autonomic neuropathy is linked to roughly a two‑fold rise in cardiovascular mortality. Prophylactic measures such as intensive glycemic control, aldose reductase inhibitors, alpha‑lipoic acid, and SGLT2 inhibitors show measurable neuroprotective effects. Conclusion: Preventive approaches addressing glycemic, metabolic, and vascular risks significantly limit the development and progression of diabetic neurological complications. Early biomarker‑based screening and multidisciplinary prophylaxis remain key strategies.
Endocrinology, Preventive Medicine, Prophylaxis, Complications: Integrating Risk Reduction Across the Endocrine Lifespan
Endocrine disorders contribute substantially to global morbidity and mortality through chronic complications that are, in large part, modifiable by prevention and early intervention across the life course. This narrative review synthesizes recent evidence (approximately 2020–2025) on preventive endocrinology with a focus on lifestyle-based primary prevention, perioperative and pharmacologic prophylaxis, and strategies to mitigate acute and chronic complications in common endocrine conditions. Prediabetes, type 2 diabetes, obesity, thyroid disease, pituitary tumors, primary aldosteronism, and treatment-related endocrinopathies are highlighted as paradigmatic conditions in which prevention frameworks are rapidly evolving. We summarize guideline updates and randomized trials on cardiovascular and microvascular complication prevention, endocrine surgery–related prophylaxis, management of immune checkpoint inhibitor–induced endocrinopathies, and emerging digital and lifestyle interventions. A conceptual model linking primary, secondary, and tertiary prevention in endocrinology is proposed, supported by illustrative comparative data and a schematic figure showing the impact of prophylactic strategies on complication rates. While substantial progress has been made, major gaps persist in long-term implementation, equity of access, and integration of precision tools into routine care. Future research should prioritize hybrid prevention models that combine technology-enabled lifestyle support, optimized pharmacotherapy, and systematic surveillance to reduce the global burden of endocrine complications.
Clinical And Prognostic Significance of Atherosclerosis in Patients with Chronic Heart Failure
Chronic heart failure is one of the most important clinical problems in modern cardiology and internal medicine. It is associated with high morbidity, frequent hospitalization, reduced quality of life and increased mortality. Atherosclerosis is one of the main pathogenetic bases of cardiovascular diseases and contributes to the development of coronary artery disease, myocardial ischemia, myocardial infarction and progressive cardiac remodeling. In patients with chronic heart failure, the presence of atherosclerosis significantly worsens the clinical course of the disease, reduces myocardial perfusion, aggravates left ventricular dysfunction and increases the risk of adverse cardiovascular outcomes. The aim of this study was to evaluate the clinical and prognostic significance of atherosclerosis in patients with chronic heart failure. The study included 128 patients with chronic heart failure of functional classes II–IV. Clinical symptoms, lipid profile, C-reactive protein, glucose, creatinine, estimated glomerular filtration rate, electrocardiography and echocardiography were analyzed. The results showed that patients with atherosclerosis had more severe heart failure, lower left ventricular ejection fraction, more frequent diastolic dysfunction, arterial hypertension, atherogenic dyslipidemia and repeated hospitalization. These findings indicate that atherosclerosis should be considered an important clinical and prognostic factor in patients with chronic heart failure.
Prophylaxis Strategies and Postoperative Complication Profiles in Open Versus Laparoscopic General Surgery: A Prospective Comparative Study at a Multidisciplinary Clinic
Background: Surgical site infections and organ-specific complications are major sources of postoperative morbidity. The surgical approach — open or laparoscopic — significantly influences complication incidence. This study compared complication profiles between the two approaches across diverse general surgical procedures. Methods: A prospective study enrolled 76 consecutive adult patients (38 open, 38 laparoscopic) at the Fergana Medical Institute of Public Health between January 2022 and December 2024, undergoing cholecystectomy, appendectomy, hernia repair, or colonic resection. Standardized prophylaxis protocols were applied uniformly. Outcomes were classified using the Clavien–Dindo system and analyzed with chi-square and t-tests (p < 0.05). Results: The overall complication rate was significantly higher in the open group (52.6% vs. 21.1%; p = 0.005). Surgical site infections occurred in 21.1% of open cases versus 5.3% of laparoscopic cases (p = 0.040). Mean hospital stay was 7.4 days for open surgery versus 3.8 days for laparoscopic surgery (p < 0.001). Conclusion: Laparoscopic general surgery is associated with substantially fewer postoperative complications and shorter hospital stay, reinforcing the case for minimally invasive access where technically feasible.
Contemporary Review of Traumatology and Orthopedics: Evidence, Innovations, and Clinical Priorities in 2024–2026
Traumatology and orthopedics are changing rapidly as clinicians respond simultaneously to aging populations, persistent high-energy trauma, increasing implant complexity, and a stronger demand for data-driven, patient-centered care. Recent literature shows that the field is moving beyond a purely mechanical model toward integrated care pathways that combine optimized timing of surgery, multidisciplinary perioperative management, modern imaging, infection prevention, digital outcomes, and selective adoption of artificial intelligence and patient-specific technologies. This review synthesizes 50 recent and real publications, with emphasis on work published in 2024–2026, to summarize current evidence across fracture care, infection prevention, imaging, risk prediction, mental health, precision orthopedics, and digital transformation. The current literature supports earlier definitive care for selected fragility fractures, standardized multidisciplinary pathways for frail and polytrauma patients, better integration of weightbearing imaging and 3D planning for complex reconstruction, and more critical appraisal of novel algorithms before routine implementation. At the same time, important gaps remain in external validation, equitable reporting, long-term functional outcomes, and implementation science, all of which should shape the next phase of orthopedic trauma research.
Clinical and Prognostic Significance of Hyperuricemia in Patients with Chronic Heart Failure and Cardiorenal Syndrome
Background: Chronic heart failure is often accompanied by renal dysfunction and cardiorenal syndrome. Hyperuricemia is increasingly recognized not only as a metabolic disorder but also as a marker of oxidative stress, inflammation, endothelial dysfunction, impaired renal perfusion, and poor prognosis. Its interaction with heart and kidney dysfunction may contribute to disease progression and increased cardiovascular risk. Objective: To evaluate the clinical and prognostic significance of hyperuricemia in patients with chronic heart failure and cardiorenal syndrome. Methods: This observational study included 142 patients with NYHA class II–IV heart failure and renal dysfunction. Clinical parameters, serum uric acid, renal function markers, inflammatory indicators, ECG, and echocardiography were assessed. Patients were divided into hyperuricemia and normouricemia groups (defined as >420 μmol/L in men and >360 μmol/L in women). Clinical severity, renal function, cardiac parameters, and hospitalization rates were compared. Results: Hyperuricemia was present in 45.1% of patients. These patients showed more advanced heart failure, lower ejection fraction, worse renal function, higher inflammatory markers, and more frequent congestion. Rehospitalization rates were higher in the hyperuricemia group. The combination of hyperuricemia, reduced eGFR, and albuminuria identified a subgroup at particularly high risk. Conclusion: Hyperuricemia has important clinical and prognostic value in chronic heart failure with cardiorenal syndrome. It may serve as a useful biomarker for risk stratification, especially when combined with renal and inflammatory markers, supporting improved monitoring and management.
Non-Alcoholic Fatty Liver Disease in Comorbid Patients: Experience with Tiotriazoline Therapy
Background: Non-alcoholic fatty liver disease (NAFLD) is a common condition associated with obesity, type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease. In comorbid patients, its progression is driven by insulin resistance, oxidative stress, and chronic inflammation. Tiotriazoline is a hepatoprotective antioxidant with potential therapeutic effects on liver injury. Objective: To evaluate the clinical and laboratory effectiveness of Tiotriazoline in comorbid patients with NAFLD. Methods: Patients with NAFLD and comorbid type 2 diabetes, obesity, and ischemic heart disease were assessed before and after therapy including Tiotriazoline. Evaluations included clinical symptoms, liver enzymes, lipid profile, glucose levels, and ultrasound signs of steatosis. Results: Treatment with Tiotriazoline was associated with improved well-being and reduced asthenic and dyspeptic symptoms. Laboratory findings showed decreased aminotransferase levels and improved metabolic parameters. The effect was more pronounced in moderate steatosis without advanced fibrosis. The therapy was well tolerated and did not worsen cardiovascular conditions. Conclusion: Tiotriazoline may be an effective component of complex therapy in NAFLD patients with comorbidities. Its antioxidant and metabolic effects contribute to improved liver function and clinical outcomes.
Hygienic Assessment of Atmospheric Air Quality in Fergana City: An Extended Resident-Based Perception and Health Symptom Study
Atmospheric air pollution is a major environmental health threat in industrial urban centers, especially in rapidly developing regions with intense industry and transport. In Fergana city, Uzbekistan, petrochemical and chemical production combined with valley topography and poor air circulation create a particularly unfavorable ecological setting. This study hygienically assessed air quality in Fergana using a resident-based perception and health symptom approach, complementing traditional technical monitoring. A cross-sectional survey of 200 residents from an industrial high-impact zone and a suburban control zone used the “Fergana-Air-Quality-Scale” to record environmental perceptions and respiratory, allergic, and sensory symptoms over 12 months. Residents near industrial plants reported more chemical odors, dust, smog, and markedly higher frequencies of persistent dry cough, conjunctival irritation, allergic rhinitis, and shortness of breath, often 2–4 times higher than in the control zone. The findings suggest that industrial emissions and unfavorable topography drive chronic exposure and elevated health risks, highlighting the need to integrate biological, social, and perceptual indicators into urban environmental hygiene assessment systems.
Occupational Health Profile and Risk Assessment of Military Communications Personnel in Modern Electronic Warfare Environments
Modern military operations depend on advanced communication systems, making communications personnel a strategically vital group. These specialists serve in highly stressful electronic warfare environments with continuous radiofrequency exposure, chronic noise, ergonomic overload, and psychological pressure. This cross-sectional analytical study of 120 military signalers operating mobile and stationary systems assessed neurological, auditory, ergonomic, and psycho-emotional health effects. Personnel with more than five years of service reported markedly higher rates of recurrent headaches, chronic fatigue, sleep disturbances, tinnitus, and lower back pain, indicating a strong link between prolonged exposure and chronic health disorders. Identified deficiencies included inadequate shielding, chronic noise, constrained working postures, and insufficient recovery. The study underscores the need to modernize occupational hygiene through improved RF shielding, noise-canceling equipment, ergonomic redesign of workplaces, structured recovery protocols, and comprehensive health monitoring.
Pediatric Ear, Nose, and Throat Diseases: Early Recognition, Management, and Outcomes
Pediatric otorhinolaryngology covers a wide range of common disorders that affect the ear, nose, throat, and upper airway in children. These conditions are important because they can interfere with hearing, speech, sleep, feeding, school performance, and quality of life. Acute otitis media, otitis media with effusion, tonsillitis, adenoid hypertrophy, and pediatric rhinosinusitis are among the most frequent diagnoses encountered in practice. Many children improve with careful observation, pain control, and targeted medical therapy, while selected patients need procedures such as tympanostomy tubes, adenoidectomy, or tonsil surgery. This article reviews the clinical burden, diagnostic approach, management principles, and developmental consequences of common pediatric ENT diseases, emphasizing the need for timely recognition and multidisciplinary care.
Pediatric Odontogenic Sinusitis: A Focused Review of Clinical Features, Surgical Management Comparisons, and Interdisciplinary Care at the Dental–Otorhinolaryngology Interface
Pediatric odontogenic sinusitis (PODS) is a rare but clinically significant condition at the intersection of dentistry and otorhinolaryngology. Defined as maxillary sinusitis arising from adjacent dental pathology, PODS remains underrepresented in paediatric rhinosinusitis guidelines despite a complication rate exceeding 80% in reported series. Its aetiology in children differs fundamentally from adults, being driven predominantly by pulpitis, periodontal abscesses, and ectopic teeth rather than implant-related disease. Diagnosis relies on contrast-enhanced computed tomography and nasal endoscopy, interpreted jointly by otolaryngologists and dental specialists. Surgical options—encompassing intranasal endoscopic sinus surgery (ESS), the Caldwell-Luc procedure, dental extraction, and combined approaches—are compared with respect to success rates, complication profiles, and the evolving evidence favouring single-stage combined ENT–dental intervention. Antibiotic therapy alone is insufficient as monotherapy. This review synthesises current evidence to propose an interdisciplinary management framework tailored to the paediatric airway-dental continuum.
Preeclampsia in Pregnancy: Pathological Mechanisms, Risk Stratification, and Evidence-Based Prevention Strategies
Preeclampsia is a hypertensive disorder of pregnancy affecting approximately 5–8% of all gestations worldwide and constitutes one of the leading causes of maternal and perinatal morbidity and mortality. Its pathogenesis is rooted in defective placentation, characterized by shallow cytotrophoblast invasion, impaired spiral artery remodeling, and subsequent placental ischemia. This triggers a systemic inflammatory cascade and endothelial dysfunction mediated predominantly by the antiangiogenic factor sFlt-1 and reduced placental growth factor (PlGF). Early identification of at-risk women through validated first-trimester combined screening—incorporating maternal history, mean arterial pressure, uterine artery Doppler, and serum biomarkers—has transformed clinical management. Evidence-based preventive interventions, chiefly low-dose aspirin initiated before 16 weeks and calcium supplementation in deficient populations, demonstrate significant risk reduction. This review synthesizes current knowledge on preeclampsia pathophysiology, diagnostic criteria, risk stratification tools, and pharmacological and non-pharmacological prevention, providing an integrated framework for contemporary obstetric practice.
Complications of Multi-Drug Regimens in Hematological Malignancies: A Case-Control Study
Background: Polypharmacy in hematological malignancies creates complex drug–drug interaction (DDI) landscapes that frequently result in severe toxicity. Objective: To quantify the prevalence, type, and clinical impact of DDIs and drug-induced organ toxicity in patients receiving combination chemotherapy regimens compared to healthy controls. Methods: A prospective case-control study enrolled 42 hematology patients receiving multi-drug regimens and 42 matched healthy controls. Complete blood counts, liver enzymes, and renal function were recorded. DDIs were classified using the Micromedex® database. Results: Major DDIs were detected in 69.0% of patients versus 0% of controls (p<0.001). Anemia (78.6%), neutropenia (66.7%), elevated ALT (61.9%), and thrombocytopenia (52.4%) were significantly more prevalent in patients. Hospital stay was markedly prolonged in the patient group (median 22 vs. 2 days). Conclusion: Multi-drug hematology regimens impose a substantial burden of clinically significant DDIs and end-organ toxicity. Systematic pharmacist-led DDI screening and prospective biomarker monitoring are essential to mitigate these risks.
Pediatric Sepsis: Evolving Diagnostic Criteria, Organ Dysfunction Complications, and Evidence-Based Management
Background: Sepsis remains a principal cause of pediatric morbidity and mortality globally, accounting for more than 3 million childhood deaths annually. The 2024 Phoenix Sepsis Criteria represent a paradigm shift from SIRS-based definitions toward organ dysfunction-centered assessment, improving diagnostic accuracy and prognostic stratification. Objective: This review synthesizes current evidence on the epidemiology, pathophysiology, complications, and management of pediatric sepsis, contrasting historical and contemporary approaches. Methods: A narrative review of publications from PubMed, EMBASE, and Cochrane Library (2000–2025) was conducted. Results: Evidence supports POCUS-guided, titrated fluid resuscitation; early broad-spectrum antibiotics within one hour; norepinephrine as first-line vasopressor; and structured post-discharge surveillance for post-intensive care syndrome in pediatrics (PICS-p). Conclusion: Integrating the Phoenix Score into clinical practice alongside personalized resuscitation protocols and long-term follow-up will meaningfully reduce sepsis-associated mortality and long-term functional impairment.
Simulation-Based Learning vs. Problem-Based Learning in Medical Education: A Comparative Study of Clinical Competency Outcomes
Background: Active pedagogical strategies have become central to competency-based medical curricula. Simulation-based learning (SBL) and problem-based learning (PBL) are two dominant modalities, yet comparative evidence from Central Asian medical institutions remains limited. Objective: To compare the effects of SBL and PBL on clinical skills, knowledge retention, critical reasoning, and student satisfaction among undergraduate medical students at FMIOPH and ASMI, Uzbekistan. Methods: A prospective quasi-experimental study enrolled 322 third-year medical students (FMIOPH SBL group: n = 163; ASMI PBL group: n = 159). Outcomes were measured via OSCE, validated MCQ assessments, and Likert-scale satisfaction surveys over one academic semester. Results: SBL students demonstrated significantly higher clinical skills scores (84.3% vs. 76.8%, p < 0.001), OSCE pass rates (86.4% vs. 79.1%, p = 0.014), and satisfaction (88.7% vs. 82.3%, p = 0.001). PBL students showed comparable critical reasoning gains (78.9% vs. 81.2%, p = 0.027). Conclusion: SBL offers superior procedural and clinical skill acquisition, while PBL effectively supports analytical reasoning. A hybrid curriculum integrating both modalities is recommended for Uzbek medical institutions.
Community-Acquired Pneumonia in Children Under Five: Etiology, Diagnosis, and Evidence-Based Management Strategies
Community-acquired pneumonia (CAP) remains the single leading infectious cause of mortality in children under five years worldwide, accounting for approximately 740,000 deaths annually. This comprehensive review synthesizes current evidence on etiology, clinical diagnosis, and management of pediatric CAP. Streptococcus pneumoniae and respiratory syncytial virus are the predominant causative organisms across all age groups. WHO severity classification guides treatment selection, with oral high-dose amoxicillin (90 mg/kg/day) recommended for non-severe cases and intravenous ampicillin combined with gentamicin for severe disease. Emerging evidence supports adjunctive zinc supplementation in malnourished children. Pneumococcal conjugate vaccine (PCV13) and influenza vaccination have demonstrated significant reductions in CAP incidence. Point-of-care diagnostics, including pulse oximetry and C-reactive protein testing, improve risk stratification in resource-limited settings. Prevention through vaccination, breastfeeding promotion, and reduction of indoor air pollution represents the most cost-effective strategy. Optimized protocols integrating severity-based antibiotic selection substantially improve outcomes in low- and middle-income countries.
Integrated Approaches to Pediatric Disease Management, Prevention, and Control in Low- and Middle-Income Countries
Background: Pediatric infectious diseases remain a leading cause of morbidity and mortality worldwide, disproportionately affecting children in low- and middle-income countries (LMICs). Objective: This review synthesizes evidence on integrated strategies for disease management, prevention, and control in pediatric populations. Methods: A structured narrative synthesis was conducted using 50 peer-reviewed publications indexed between 2015 and 2024, encompassing randomized controlled trials, systematic reviews, and national surveillance reports. Results: Vaccination programs, oral rehydration therapy, antibiotic stewardship, nutritional supplementation, and the Integrated Management of Childhood Illness (IMCI) framework collectively demonstrated significant reductions in both mortality and morbidity. IMCI and vaccination yielded the highest impact, reducing mortality by 67% and 72%, respectively. Conclusion: Implementing integrated, evidence-based protocols within primary care systems offers a scalable pathway to improving pediatric health outcomes globally.
Viral Protection Strategies During Pandemic Periods: A Comprehensive Evidence-Based Review of Prevention Protocols and Outcomes
Viral pandemics represent recurrent global health crises that demand multi-layered prevention strategies encompassing non-pharmacological interventions (NPIs), vaccination programs, environmental engineering controls, and digital surveillance systems. This comprehensive review synthesizes evidence from 50 high-quality publications sourced from Q1–Q2 journals to evaluate the comparative efficacy of viral protection methods deployed during major pandemic periods, including the 1918 Influenza, 2009 H1N1, 2012 MERS-CoV, 2014 Ebola, and 2019–2023 SARS-CoV-2 outbreaks. Evidence consistently demonstrates that layered NPIs—including FFP2/N95 respirators, WHO-compliant hand hygiene, and strict physical distancing—reduce transmission by 67–95%. mRNA vaccination platforms achieve efficacy exceeding 90% against ancestral strains. Environmental controls such as HEPA filtration and UV-C germicidal irradiation provide supplementary pathogen reduction in healthcare and community settings. Integrated test-trace-isolate (TTI) protocols further attenuate reproductive numbers. Health systems must institutionalize adaptive preparedness frameworks that combine these evidence-based modalities to mitigate future pandemic mortality and morbidity.
Optimizing Antibiotic Stewardship in Pediatric Community-Acquired Pneumonia: Clinical Pathways, Outcomes, and Emerging Challenges
Community-acquired pneumonia (CAP) remains one of the foremost causes of pediatric morbidity and hospitalization globally. Inappropriate antibiotic prescribing in this population not only prolongs hospital stays but accelerates antimicrobial resistance—a public health crisis of mounting concern. This article reviews the epidemiology, diagnostic approach, and contemporary management strategies for CAP in children aged three months to eighteen years. We examine evidence underpinning guideline-concordant narrow-spectrum antibiotic therapy, clinical pathway (CP) implementation, and the intravenous-to-oral antibiotic switch strategy. Comparative analysis demonstrates that structured antimicrobial stewardship interventions significantly increase narrow-spectrum antibiotic use and reduce broad-spectrum prescribing without compromising clinical outcomes. Results indicate that CP adoption is associated with reduced length of stay, earlier IV-to-oral switching, and shortened antibiotic courses. These findings underscore the urgent need for integrated, evidence-based protocols at regional hospitals in Central Asia and similar low-to-middle-income settings.
Problem-Based Learning Transforms Histology Education: Evidence from Uzbekistan Medical Students
This study compares educational outcomes of Problem-Based Learning (PBL) and traditional didactic instruction in medical biology and histology at two Uzbek medical institutions. A cohort of 21 first-year students at the Fergana Medical Institute of Public Health (FMIOPH) received PBL-based instruction, while 212 students at the Andijan State Medical Institute (ASMI) were taught through conventional lecture methods. Outcomes assessed included histological identification accuracy, clinical reasoning, long-term knowledge retention, collaborative skill development, examination performance, and student satisfaction. Independent-samples t-tests and Mann-Whitney U tests revealed statistically significant advantages for the PBL group across all domains (p<0.01). PBL students demonstrated markedly higher scores in collaborative skills (91.3% vs. 59.7%) and clinical reasoning (84.2% vs. 65.8%). These findings support wider adoption of PBL frameworks in Central Asian medical curricula and underscore the need for institutional investment in faculty training and case development.
Complications of Otorhinolaryngologic Procedures in Teenagers: A Procedure-Based Comprehensive Review of Management and Prevention Strategies
Otorhinolaryngologic (ENT) procedures are among the most frequently performed surgical interventions in the teenage population. Despite technical advances, complications ranging from post-tonsillectomy hemorrhage and tympanostomy tube sequelae to cochlear implant device failure, nasal surgical morbidity, and laryngoscopy-associated airway injury remain clinically significant. This review systematically examines complications occurring after five major ENT procedure categories—tonsillectomy and adenoidectomy, myringotomy with tympanostomy tube insertion, cochlear implantation, nasal surgery (septoplasty, functional endoscopic sinus surgery, and rhinoplasty), and laryngoscopy or bronchoscopy—in teenagers aged 10–19 years. For each procedure, intraoperative, short-term, and long-term complications are described alongside evidence-based management strategies and prevention protocols. Emphasis is placed on the unique anatomical, physiological, and psychosocial characteristics of adolescents that modulate risk profiles and recovery trajectories. The review consolidates 60 publications from 2018 to 2026 drawn from PubMed, JAMA, Otolaryngology–Head and Neck Surgery, and Frontiers in Neuroscience databases.
Pathomorphological and Histochemical Changes in Regional Lymph Nodes in Alcoholic Pancreatitis: An Autopsy-Based Analysis
Background: Alcoholic pancreatitis induces systemic immunological responses that are reflected in the lymphatic apparatus of the pancreas. The regional lymph nodes serve as critical immunological sentinels, yet their structural and histochemical alterations remain incompletely characterised. Methods: Autopsy material from regional pancreatic lymph nodes was obtained from 40 deceased individuals: 22 with acute alcoholic pancreatitis (AP), 18 with chronic AP, and 10 controls. Haematoxylin-eosin, Masson's trichrome, PAS, Alcian Blue, Sudan III, and Gomori silver staining were applied. Semi-quantitative scoring and statistical analysis were performed. Results: Both forms of AP demonstrated significant lymphoid hyperplasia, sinus histiocytosis, and paracortical expansion. Acute AP showed pronounced haemorrhagic infiltration and necrotic foci, whereas chronic AP exhibited dominant fibrotic remodelling and glycogen depletion. Histochemical analysis revealed progressive accumulation of acid mucopolysaccharides and neutral lipids alongside reticular fibre fragmentation. Conclusion: Regional lymph nodes in alcoholic pancreatitis undergo distinct morphological and histochemical transformations depending on disease acuity, reflecting dynamic immune dysregulation and stromal remodelling.
Preventive Strategies for Reducing Complications of Viral Diseases: A Comprehensive Review
Background: Viral infections remain a dominant cause of preventable morbidity and mortality worldwide, generating a wide spectrum of acute and long-term complications. Objective: This review synthesizes current evidence on preventive strategies targeting viral disease complications, spanning vaccination, early antiviral therapy, non-pharmaceutical interventions (NPIs), passive immunization, and health system-level measures. Methods: A narrative review of peer-reviewed literature published between 2020 and 2025 was conducted using PubMed, Scopus, and Web of Science databases. Results: Vaccination remains the cornerstone of prevention, reducing severe outcomes by 70-95% across major viral pathogens. Early antiviral administration significantly mitigates post-acute sequelae. Combined NPIs effectively interrupt transmission chains. Passive immunization and digital surveillance offer complementary layers of protection. Conclusion: Multi-tiered, evidence-based preventive frameworks are essential for reducing the global burden of viral disease complications. Integration of pharmacological and non-pharmacological strategies within robust public health systems represents the most effective approach.
Transforming Histology and Biomedicine Education Through Modern Digital and Active-Learning Methods: Evidence from Medical Student Cohorts
Background: Histology is a foundational discipline in biomedical education, yet conventional microscopy-based methods increasingly fail to engage contemporary medical students or to develop higher-order diagnostic reasoning. Methods: This study compared five instructional approaches — traditional microscopy (TM), virtual microscopy (VM), blended learning (LM+VM), problem-based learning (PBL), and gamification — in 220 first- and second-year medical students at the Fergana Medical Institute of Public Health. Pre- and post-intervention scores, student satisfaction, and qualitative feedback were recorded. Results: Blended learning achieved the highest post-intervention score (83.2 ± 5.0%) and satisfaction (91.2%), followed by VM and PBL. All modern methods significantly outperformed TM. Conclusion: Integrating digital and active-learning strategies into histology and biomedicine curricula substantially improves academic outcomes and student engagement.
Adiponectin as a Non-Invasive Biomarker for Early Hepatic Steatosis Detection in Chronic Hepatitis B and Delta Coinfection
Background: Hepatic steatosis complicates the clinical course of chronic hepatitis B (CHB) coinfected with hepatitis delta virus (HDV), yet reliable non-invasive early detection tools remain limited. Objective: To evaluate serum adiponectin as an early diagnostic biomarker of hepatic steatosis in CHB-HDV coinfected patients. Methods: A cross-sectional study enrolled 130 CHB-HDV patients stratified by controlled attenuation parameter (CAP). Serum adiponectin was measured by ELISA and correlated with steatosis grade, metabolic indices, and liver enzymes. Results: Adiponectin levels declined significantly with increasing steatosis severity (S0: 12.4 ± 0.8 μg/mL; S3: 4.3 ± 0.5 μg/mL; p < 0.001). An adiponectin threshold of 6.0 μg/mL yielded sensitivity of 82% and specificity of 79% for hepatic steatosis. Negative correlations were observed with BMI, HOMA-IR, ALT, and viral load. Conclusion: Serum adiponectin is a practical, cost-effective, and minimally invasive biomarker for early identification of hepatic steatosis in CHB-HDV coinfection, supporting its integration into routine hepatological screening.
Airway Hyperresponsiveness in Pediatric Recurrent Respiratory Illness: Diagnostic Approaches and Therapeutic Strategies
Background: Airway hyperresponsiveness (AHR) is a hallmark feature of obstructive airway disease in children and adolescents, yet it remains underdiagnosed in those presenting with recurrent respiratory illnesses. Objective: To evaluate the prevalence, severity, and clinical correlates of AHR in pediatric patients and to compare the diagnostic performance of multiple instrumental techniques alongside therapeutic responses. Methods: A combined retrospective and prospective study was conducted at the Pulmonology Department of the Fergana City Children’s Hospital over three years (2021–2024), enrolling 78 patients aged 5–17 years with recurrent respiratory illness and 78 healthy age- and sex-matched controls. Spirometry, methacholine challenge testing, fractional exhaled nitric oxide (FeNO), and impulse oscillometry were applied. Results: AHR was confirmed in 71.8% of the main group. Median PC20 was 2.4 mg/mL in bronchial asthma patients versus 22.5 mg/mL in controls (p < 0.001). FeNO levels were significantly elevated. Conclusion: Methacholine challenge combined with FeNO measurement provides optimal diagnostic sensitivity for AHR in children, and stepwise inhaled corticosteroid therapy remains the cornerstone of effective management.
Integrated Prevention and Clinical Management of Childhood Pneumonia: Evidence-Based Strategies for Reducing Under-Five Mortality
Background: Childhood pneumonia remains the single leading infectious cause of death in children under five years of age globally, accounting for approximately 14% of all under-five mortality. Objective: This review synthesizes current evidence on the prevention and integrated management of pediatric pneumonia, with particular attention to vaccine-preventable strategies, antimicrobial stewardship, and supportive care protocols. Methods: A narrative review of peer-reviewed literature published between 2015 and 2025 was conducted using PubMed, Scopus, and WHO databases. Results: Vaccination with pneumococcal conjugate vaccine (PCV) and Haemophilus influenzae type b (Hib) vaccine has substantially reduced bacterial pneumonia burden. Nirsevimab demonstrates an 87% reduction in RSV-associated lower respiratory tract disease. Integrated community case management (iCCM) and pulse oximetry-guided oxygen therapy have improved clinical outcomes. Conclusion: A multi-pronged approach combining immunization scale-up, early diagnosis, and evidence-based treatment reduces childhood pneumonia mortality. Strengthening health system capacity in low- and middle-income settings remains essential.
Integrated Prevention and Management of Leading Infectious Diseases in Children Under Five: A Narrative Review of Evidence-Based Strategies
Background: Infectious diseases remain the dominant cause of under-five mortality worldwide, with pneumonia, diarrhea, and vaccine-preventable diseases collectively accounting for more than a third of the 4.8 million childhood deaths recorded in 2023. Purpose: This narrative review synthesises current evidence on the prevention and clinical management of the principal infectious diseases affecting children under five years of age, with emphasis on integrated approaches applicable in resource-limited settings. Methods: A structured literature review was conducted across PubMed, EMBASE, Cochrane Library, and WHO databases, covering publications from 2000 to 2025, with priority given to systematic reviews, meta-analyses, and randomised controlled trials. Results: Immunisation, oral rehydration therapy, exclusive breastfeeding, zinc supplementation, and facility-based integrated management strategies (IMCI) demonstrate the highest level of evidence for reducing childhood morbidity and mortality. A comparative table and trend analysis are presented. Conclusion: Sustained investment in integrated, community-based preventive programmes and equitable vaccine coverage is essential to accelerating progress toward eliminating preventable child deaths.
Dietary Micronutrient Optimization and Nutritional Interventions for Prevention of Acute Viral Respiratory Infections
Viral respiratory infections remain a major public health concern globally, affecting millions annually and causing significant morbidity and mortality. Growing evidence demonstrates that nutritional status critically influences immune competence and susceptibility to infection. This review synthesizes current research on dietary interventions and micronutrient supplementation for prevention of acute viral infections. Key nutrients including vitamins C, D, E, zinc, and selenium have demonstrated immunomodulatory properties and antiviral effects in clinical and pre-clinical studies. Mediterranean and DASH dietary patterns, rich in polyphenols and antioxidants, show promise in reducing infection severity through anti-inflammatory mechanisms. Probiotics and prebiotics enhance gut microbiota composition, strengthening the gut-lung axis and improving respiratory immune responses. Adequate protein, omega-3 fatty acids, and micronutrient status are essential for optimal antibody production and T-cell maturation. Malnutrition, including both undernutrition and obesity, significantly increases vulnerability to severe viral infection outcomes. This comprehensive analysis emphasizes the importance of balanced nutrition as a cost-effective, accessible preventive strategy for reducing viral infection incidence and severity across diverse populations.
Postoperative Complications in Minimally Invasive Versus Open Abdominal Surgery: A Comparative Analysis of Outcomes and Risk Factors
Background: Surgical site complications remain a leading cause of morbidity following abdominal procedures. Comparing minimally invasive and open surgical techniques provides essential evidence for optimizing clinical outcomes. Methods: A comparative analysis was conducted examining wound infection rates, anastomotic leak rates, 30-day mortality, and mean hospital stay across five surgical modalities: open laparotomy, laparoscopic surgery, robotic-assisted surgery, video-assisted thoracoscopy, and hybrid approaches. Data were synthesized from the current literature. Results: Robotic-assisted surgery demonstrated the lowest wound infection (3.7%) and 30-day mortality rates (0.9%), along with the shortest hospital stay (4.1 days). Open laparotomy retained the highest complication burden across all indices. Conclusion: Minimally invasive approaches yield significantly superior postoperative profiles. Wider adoption, supported by ERAS protocols and robust perioperative care, is strongly advocated.
Comparative Analysis of English Language Teaching Techniques for Medical Students: Evidence-Based Approaches
Background: Proficiency in English is indispensable for medical students who must access international literature, communicate with global peers, and present research findings. Yet conventional language instruction rarely addresses the specific lexical and communicative demands of medical education. Objective: This article reviews and compares seven evidence-based English language teaching (ELT) techniques adapted for medical study contexts: Content-Based Instruction, Task-Based Language Teaching, flipped classroom, corpus-based learning, simulation and role-play, Mobile-Assisted Language Learning, and extensive reading/writing. Methods: A systematic comparative review of 50 peer-reviewed publications (2018–2025) was conducted. Techniques were evaluated across four dimensions: learning outcomes, student engagement, applicability, and evidence level. Results: Content-Based Instruction and Task-Based Language Teaching demonstrated the strongest outcomes for medical contexts. Simulation and role-play showed exceptional communicative gains. Conclusion: An integrated, context-sensitive approach combining multiple techniques offers the most effective pathway for English language acquisition in medical education.
Postoperative Complication Profiles in Minimally Invasive Versus Open Abdominal Surgery: A Comparative Outcome and Risk Factor Analysis
Background: Minimally invasive surgery (MIS) has progressively replaced open abdominal surgery across multiple surgical disciplines, yet comparative outcome data in diverse patient populations remain essential for guiding clinical decision-making. Objective: To compare postoperative complication rates, recovery parameters, and identifiable risk factors between MIS and conventional open surgery in adult patients undergoing elective abdominal procedures. Methods: A retrospective comparative analysis was conducted on 400 patients operated between January 2021 and December 2023. Outcomes including surgical site infection, anastomotic leak, postoperative ileus, pneumonia, blood loss, operative time, hospital stay, and 30-day mortality were recorded and analyzed. Results: MIS was associated with significantly shorter hospital stay, reduced blood loss, lower rates of anastomotic leak, ileus, and pneumonia compared to open surgery. Obesity, diabetes mellitus, and high ASA classification were the most significant predictors of complications. Conclusion: MIS confers measurable short-term outcome advantages over open abdominal surgery and should be the preferred approach when clinically feasible.
Minimally invasive gynecologic procedures, complications, management, and prevention: an updated narrative review for contemporary practice
Minimally invasive and conventional gynecological procedures are central to the diagnosis and treatment of benign and malignant conditions, but they carry distinct intraoperative and postoperative risks that require structured prevention and management strategies. This narrative review synthesizes recent literature on common gynecologic procedures, focusing on laparoscopic, hysteroscopic, vaginal, and abdominal approaches, and summarizes typical complications such as visceral and vascular injury, hemorrhage, infection, thromboembolism, and anesthesia-related events. Evidence-based preventive measures—including careful preoperative risk stratification, standardized surgical checklists, optimal trocar entry techniques, antibiotic prophylaxis, and enhanced recovery protocols—are discussed alongside practical intraoperative and postoperative management algorithms. Particular attention is paid to the prevention and treatment of complications during gynecologic laparoscopy, where bowel and urinary tract injuries predominate and vessel injuries, although less frequent, contribute substantially to morbidity. The review concludes with patient-centered strategies for long‑term prevention, emphasizing regular preventive gynecologic care, vaccination, and lifestyle modification as integral components of complication avoidance across the reproductive life course.