In the modern world, it is widely recognized that oxidative stress, characterized by an imbalance between free radicals and antioxidant protection, is considered as a key factor in the pathophysiology of various diseases and is the object of active study. Cell damage occurs due to oxidative stress, which leads to the formation of specific products of interaction with DNA, lipids and proteins with the participation of hydroxyl radicals. The antioxidant defense of the body includes both enzymatic and non-enzymatic molecules regulated by hormones that control their synthesis and turnover.

Studies show that both hypothyroidism and hyperthyroidism can be associated with oxidative stress, which can contribute to the development of pathology in various organs, as well as in the thyroid gland itself. However, there is insufficient data on potential changes at the level of biological chemistry, for example, a violation of purine metabolism; in this review, we consider the regulation of antioxidants by thyroid hormones and oxidative stress in normal and impaired thyroid function. This hormonal imbalance is a compensatory mechanism that requires further study of the possibility of substitution therapy. Thus, the assessment of the parameters of oxidative stress can make a significant contribution to understanding its role in pathophysiology.

Aim. To summarize existing approaches to the use of artificial intelligence in the diagnosis of heart failure, to characterize the algorithms and models employed, to describe the types of medical data used (ECG, echocardiography, EMR, CT/MRI, angiography, wearables), to evaluate model performance (accuracy, AUC, sensitivity/specificity), and to assess feasibility and prospects for clinical implementation – with particular attention to the situation and challenges in Kazakhstan.

Materials and methods. Systematic searches of PubMed, Scopus, Web of Science, IEEE Xplore and Google Scholar (2015 – 2025) identified peer-reviewed English and Russian studies on AI applications for heart failure diagnosis; two reviewers independently screened articles, extracted data and assessed quality, and results from 60 eligible studies were synthesized narratively with quantitative pooling where appropriate.

Results and discussion. Across 60 eligible studies (2015 – 2025), AI applied to ECG, echocardiography, EMRs, imaging and wearable data demonstrated diagnostic accuracy typically between 85-95% (AUCs up to 0.97); ECGbased algorithms reliably detected HFrEF, AI-assisted echocardiography improved segmentation and reduced operator dependence, multimodal models enhanced prediction of therapy response (including CRT), while implementation in Kazakhstan remains nascent due to infrastructure and data-access limitations.

Conclusion. Artificial intelligence is a promising direction in heart-failure diagnostics that can enhance the accuracy, timeliness and personalization of clinical decisions. For large-scale clinical adoption – especially in Kazakhstan – prospective validation, standardized protocols, local representative datasets, robust digital infrastructure and workforce training are required.

A review of modern approaches to the prevention, treatment and rehabilitation of occupational dust-related lung diseases, including chronic obstructive pulmonary disease, with an emphasis on maintaining working capacity, is realized. The analysis of scientific literature, including articles, guidelines and recommendations of professional associations, with an assessment of the levels of evidence, is carried out. The pathogenetic principles of treatment, medicinal and non-medicinal methods (pulmonary rehabilitation, physiotherapy, balneotherapy), their effectiveness in improving respiratory function, quality of life and reducing disability are described. Prevention includes technical, hygienic and medical measures.

Chronic obstructive pulmonary disease of occupational etiology remains a global problem requiring an integrated approach. Existing methods are effective, but new solutions for prevention and rehabilitation are needed.

Chronic diffuse liver diseases (CDLD) is a collective concept that unites diseases of various etiologies, accompanied by the development of diffuse damage to the liver parenchyma, which is characterized by deviations from the norm in biochemical markers of liver function and lasts more than 6 months.

In recent decades, CDPD has been the subject of active study by hepatologists and close attention from practicing physicians. First of all, this is due to the fact that the prevalence of liver diseases is increasing every year all over the world, and most often this pathology develops in people of working age, significantly reducing their quality of life.

Data from modern literature indicate that currently chronic liver diseases occupy a significant place among the causes of early disability and mortality of the population.

On average, there are more than 2 billion people worldwide suffering from chronic diffuse liver disease (CDLD), which is 100 times higher than the prevalence of HIV infection. In this case, the main contingent of patients becomes, as a rule, the able-bodied, socially active part of the population. CDPD include a wide range of nosologically independent inflammatory diseases of various etiologies

Thus, liver lesions of various etiologies occur in approximately the same sequence, called the “liver continuum”, the final link of which is HCC. Therefore, not only effective therapy and measures to prevent the development of CDPD themselves, but also the ability to productively intervene in this continuum are currently one of the most pressing problems of modern hepatology.

Given the paucity of epidemiological data from regions of Asia, Africa and Latin America, and the lack of consistency in regional and age-specific patterns of prevalence of chronic diffuse liver disease, further research is required to identify the global burden of the disease.

The purpose of this review was to search for literature data on the prevalence of diffuse infiltrative and inflammatory liver diseases of various etiopathogenesis.

To achieve this goal, publications of foreign authors in the Scopus and Pubmed databases were analyzed. Taking into account the depth of the search - the last 10 years, the language of publication - Russian, English, 38 full-text articles were included in the analysis

Whooping cough, an acute respiratory infection characterized by paroxysmal coughing, remains one of the significant causes of morbidity and mortality among children worldwide, despite the successes of vaccination. According to the World Health Organization, approximately 60 million people are infected with whooping cough each year, of which about 1 million are children under one year old. Alongside high vaccination coverage, many developed countries such as the USA, Australia, and the Netherlands are facing epidemics of whooping cough. Official statistics on morbidity may not reflect the true picture, as only 10-12% of cases are diagnosed.

The aim of this study is to analyze the dynamics of the epidemiological process of whooping cough in the Aktobe region of the Republic of Kazakhstan over the period of 2020-2024. The study utilized statistical data on whooping cough morbidity from the Department of Sanitary and Epidemiological Control for the specified period.

The analysis showed an uneven distribution of whooping cough morbidity, with a marked increase in cases in 2024 compared to previous years. The main factors contributing to the rise in morbidity are the decrease in vaccination coverage and the antivaccine sentiments among the population. According to the Ministry of Health of the Republic of Kazakhstan, 1440 cases of whooping cough were registered at the beginning of 2024, significantly exceeding the figures for 2023.

This study highlights the need to increase vaccination rates and raise public awareness about the risks associated with whooping cough.

Aim. Infections caused by highly oncogenic HPV types can persist in the human body, which increases the risk of developing severe cervical lesions with their subsequent progression to invasive cervical cancer. The aim of this study was to investigate the socio-demographic characteristics of patients with precancerous diseases of the cervix and analyze the relationship between HPV infections and cervical precancerous diseases.

Materials and methods. Data on the cervix and HPV infections were collected from 402 women included in the scientific project «National Program for the Study of HPV with the Development of an Integrated Approach to Effective Diagnosis and Treatment of Precancerous Conditions» between 2024 and 2026. The study is being conducted within the framework of program-targeted funding from the Ministry of Science and Education of the Republic of Kazakhstan.

Results and discussion. The average age of women in our study with a positive HPV test result was 33.08±6.62 years. Among women infected with HPV, every third woman was not married – 31.2%, the divorce rate is 12.8%. The barrier method of contraception is used in 33.8% of sample population. Furthermore, among HPV-infected women the usage of barrier contraception is 1.2 times higher. HPV-16 and HPV-52 were the most common types in patients with both normal and abnormal cytology. Mild and severe dysplasia were more frequently observed in HPV types 16, 33, 52, and 58.

Conclusion. Socio-demographic factors such as age and marital status have a significant impact on the risk of HPV infection. Young women and unmarried women, women with full-day work hours have a higher level of infection.

Objective. Evaluation of the dynamics of epicardial fat thickness (EFT) in overweight patients after coronary artery bypass grafting in comparison with the dynamics of this indicator in individuals with normal body weight who underwent coronary artery bypass grafting.

Materials and methods. The cohort study involved 91 patients. All patients were divided into 2 groups: group 1 – overweight patients after coronary artery bypass grafting (n=48) and group 2 – patients with normal body weight after coronary artery bypass grafting (n=43). The patients were examined on the first day after the blood flow was restored, then at the 1^st, 2^nd and 3^rd stages of rehabilitation. A clinical examination, general examination with anthropometry, measurement of blood pressure and determination of body mass index were conducted. Among the instrumental research methods, transthoracic echocardiography was used. Statistical analysis of the data was carried out using the STATISTIC 12 software.

Results and discussion. In group 1, at different stages of rehabilitation, it was revealed that the epicardial fat thickness index on the first day after coronary artery bypass grafting was 4.14±1.63, at the first stage of rehabilitation it decreased to 4.11 ±1.37, at the second stage it decreased to 3.69±0.66 and at the third stage of rehabilitation it increased to 4.54±1.28.

Conclusions. In overweight patients who underwent coronary artery bypass grafting, in the postoperative period, the thickness of epicardial fat was 2 times higher than the thickness of epicardial fat in patients who also underwent coronary artery bypass grafting, but had a normal body weight.

In overweight patients after coronary artery bypass grafting, the thickness of epicardial fat was statistically significantly higher by the 3rd stage of cardiorehabilitation compared to this indicator in them before the start of rehabilitation measures and significantly higher compared with the thickness of epicardial fat in patients with normal body weight who underwent coronary artery bypass grafting.

An increase in epicardial fat thickness in combination with an increase in the left ventricular myocardial mass index can be considered as a predictor of insufficient effectiveness of cardiorehabilitation measures and destabilization of lipid metabolism in the epicardium of overweight patients who underwent coronary artery bypass grafting.

Aim. To determine the effect of small interfering RNAs on the expression of immune response genes in peripheral blood mononuclear cells of patients with rheumatoid arthritis.

Materials and methods. Peripheral blood mononuclear cells from patients with rheumatoid arthritis were isolated by density gradient centrifugation. Small interfering RNAs were introduced into peripheral blood mononuclear cells via transfection using commercial reagents (Lipofectamine). Gene expression was evaluated by real-time PCR (ΔΔCt, log₂ Fold Change) 48 hours after gene knockdown. GAPDH expression was used as an endogenous control. Statistical analysis included the nonparametric Mann – Whitney U test (p = 0.05).

Results and discussion. Transfection of peripheral blood mononuclear cells with specific small interfering RNAs targeting IFN-γ, IL-4, TLR4, and TLR7 resulted in 43,9% decrease in TLR4 expression (p=0.0286) and 38.4% decrease in TLR7 expression (p=0.0211).

Conclusion. The study confirmed the relevance of peripheral blood mononuclear cells using as an in vitro model for investigating molecular mechanisms, demonstrating their ability to reproduce features of the immune response. Successful transfection of target small interfering RNAs against key genes showed high precision and efficiency of the chosen method and led to a significant reduction in gene expression. Particular attention should be paid to the identified ability of small interfering RNAs to effectively suppress TLR4 and TLR7 expression, which demonstrates both the functionality of the small interfering RNAs and the susceptibility of these targets to silencing. Post-transcriptional reduction of mRNA levels is of fundamental importance, indicating that toll-like receptors are promising candidates for molecular intervention.

Aim. To study the clinical and morphological risk factors for the development of radioiodine resistance in patients with highly differentiated thyroid cancer.

Materials and methods. The study was conducted among patients treated at the radionuclide therapy department of the Centre for Nuclear Medicine and Oncology of the Abay Regional Health Department. For the analysis, a database of patients who underwent radioiodine therapy was created, which included 630 patients who underwent treatment for thyroid cancer between January 2021 and December 2023. Of these, 373 medical records met the established criteria for inclusion in the study. The statistical analysis was performed using the SPSS 20.0 program.

Results and discussion. During the analysis of 373 patients, 60 were assigned to the main group with resistance to radioiodine therapy, and the remaining 313 were in the control group. When assessing the volume of surgery, total thyroidectomy with fascial-caseal excision of the neck tissue was performed for 58.3% of patients in the main group, characterized by resistance to radioiodine therapy, whereas in the control group, this volume of intervention was performed only in 29.1% (p<0.001). The main histological types of thyroid cancer in the study groups were papillary cancer (74.5%) and follicular cancer (25.5%). The presence of microcarcinoma against the background of these histological types of cancer was found in 8 patients of the control group. The presence of distant metastases was significantly more common in the main group (23.3% vs 7.3%) compared with the control (p<0.001).

Conclusions. Based on the analysis, it can be concluded that, in particular, total thyroidectomy with lymph node dissection is statistically more often observed in patients with resistance to radioiodine therapy. However, surgical treatment itself is not a causal factor in the development of radioiodine resistance. Most likely, the expanded scope of surgery reflects a more aggressive course of the disease, which is initially associated with the risk of developing radioiodine-resistant forms of tumor. Histological examination data, detection of microcarcinoma, and the presence of distant metastases should be considered as clinical and morphological factors associated with the risk of developing resistance to radioiodine therapy in patients with highly differentiated thyroid cancer.

Relevance. COVID-19, caused by the SARS-CoV-2 virus, is characterized by a wide range of clinical manifestations, from asymptomatic to critical forms with multiple organ failure. One of the key prognostic factors of the severity of the disease is the degree of damage to the lung tissue according to CT data, reflecting the severity of the inflammatory and immune response. Patients retain symptoms after the acute period, including fatigue, cognitive impairment, and myalgia, the pathogenesis of which is not fully understood. Current data indicate a significant role of metabolic disorders in the development of Long COVID-19. It has been shown that in patients with severe COVID-19 and higher CT scores, there is a decrease in tryptophan levels, activation of its catabolism via the kynurenine pathway, as well as an increase in trimethylamine N-oxide (TMAO) levels, which have proinflammatory activity. Despite numerous studies, there is insufficient data on the role of tryptophan and trimethylamine N-oxide molecules in the pathogenesis of Long COVID-19 and their relationship to severity during acute COVID-19.

Aim. To study the relationship between the degree of lung damage in acute COVID-19 and tryptophan and TMAO levels in patients with Long COVID-19.

Materials and methods. The retrospective cohort study was conducted, which included 30 people. The concentration of tryptophan and TMAO in the patients' plasma was determined using the method of highly efficient liquid chromatography with mass-selective mass spectrometric detection (HPLC-MS/MS).

Results and discussion. As a result, the median tryptophan level in the moderate group was 9.62 [8.11; 10.50] mcmol/l, in the severe group was 4.68 [2.81; 5.05] mcmol/l, respectively. The median TMAO level in the moderate group was 0.57 [0.51; 0.81] mcmol/l, in the severe group 1.88 [1.07; 3.08] mcmol/l.

Conclusions. Statistically significant differences were found between tryptophan levels and the moderate and severe groups. The significance level when comparing tryptophan concentrations was p=0.000. Statistically significant differences were also found between the level of TMAO and the severity of patients, the significance level was p<0.001. 

Aim. Study of the state of blood homeostasis in female rats under isolated and combined exposure to hexavalent chromium and gamma radiation.

Materials and methods. The experiment included groups of rats exposed to gamma radiation, as well as combined exposure to gamma radiation and chromium. In the acute phase, peripheral blood parameters, markers of oxidative stress (MDA, SOD, CAT) and cytokine status (IL-1-beta, IL-6, IL-10, TNF-α) were evaluated.

Results and discussion. Gamma radiation significantly reduced antioxidant protection (SOD, CAT) and caused severe inflammation (increased the level of IL-1-beta). These changes were statistically significant, and the high correlation between the groups confirmed the reliability of the results. The mechanisms of induced mutagenesis under combined exposure are associated with increased free radical oxidation and depletion of the antioxidant system.

Conclusions. Combined exposure to hexavalent chromium and gamma radiation causes more severe homeostasis disorders compared to isolated use. The data suggest the need to develop chemoprophylaxis methods to reduce cancer risks, especially in cases where carcinogens have a combined effect.

Relevance. Modern urological practice demands the search for and implementation of highly effective and biocompatible bulking materials capable of ensuring a stable clinical outcome with minimal risk of complications. The use of bulking agents is particularly significant in reconstructive and functional urology, where both aesthetic and functional outcomes are critically important. Currently, a variety of synthetic and biological materials are employed; however, each possesses certain limitations related to resorption, immunogenic reactions, and the risk of fibrosis. In this regard, the development and comparative analysis of new, combined approaches incorporating autologous components with high biocompatibility is a highly relevant research direction.

Aim. To conduct a comparative comprehensive evaluation of the efficacy and biocompatibility of various synthetic and autologous bulking agents used in urological practice, utilizing morphological and morphometric methods of analysis.

Materials and methods. The study involved 80 male Belgian rabbits, each receiving a submucosal injection of 0.3 mL of a bulking substrate into the bladder wall. All cases were divided into five groups. At 14 and 30 days post-injection, histological, histochemical, histomorphometric, and morphometric analyses were performed to objectively assess the inflammatory response, vascularization, cellular infiltration, degree of fibrosis, and transplant integrity.

Results and discussion. The findings demonstrated that the combination of autologous lipotransplantation with platelet-rich plasma (PRP) exhibited more pronounced vascular network formation, reduced inflammation, and a more homogeneous distribution of transplanted tissue compared to other groups. This indicates high biocompatibility and the potential of this combination as an alternative to synthetic materials, particularly in cases requiring a long-lasting volumizing effect with minimal risk of complications.

Conclusion. The combination of PRP with autologous lipotransplantation, as well as the application of Vantris, appears to be among the most promising approaches for achieving a stable and biocompatible bulking effect in the correction of lower urinary tract pathologies. Nevertheless, despite the high short-term biocompatibility of the studied materials, questions regarding their long-term safety, the risk of fibrosis, and potential functional impairments of the bladder remain unresolved and warrant further clinical validation.

Aim. Study of the anatomical and morphological analysis of the above-ground and underground parts of Iris scariosa L., as well as identification of diagnostic characteristics.

Materials and methods. The object of the study were the above-ground and underground parts of Iris scariosa Willd. ex Link, collected in Central Kazakhstan (Karaganda region) in May-July 2024. The identification of raw materials was carried out at the Department of Botany of the Biological and Geographical Faculty of Buketov Karaganda University NC JSC. During the study, cross-sections and surface preparations of both above-ground and underground plant organs were prepared.

Results and discussion. The results of the analysis allowed us to identify characteristic features of the structure of the organs of Iris scariosa L., which is important for understanding its biology and potential use in medicine. In addition, the study identified diagnostic features that can be used in pharmacognosy to identify and confirm the authenticity of plant materials.

Conclusions. The obtained data on the structure of leaves, flowers and rhizomes are of great importance for understanding the biology of the plant and its adaptation to the conditions of Central Kazakhstan. The results of this study can serve as a basis for further work on studying the biological properties of Iris scariosa L. and its potential use in medicine and pharmaceuticals.

Currently, various modified aerosol dosage forms, namely sprays, are becoming increasingly widespread. At the same time, the theoretical foundations for creating sprays in pharmaceutical technology have not been fully studied, and there is no clear answer to what a spray is a modification of aerosols or an independent dosage form. Sprays are of undoubted theoretical interest and have practical significance for pharmacy, medicine and cosmetology. The paper presents studies on the development of the composition and technology for obtaining an oral spray based on a thick extract of Inula helenium L. The spray, having the advantages of an aerosol package, is devoid of the disadvantages associated with the use of bottles under high pressure and the use of propellants as a carrier gas: relatively high cost, complexity, danger, the possibility of a cylinder explosion upon impact or storage at inappropriate temperature conditions, high flammability, fire and explosion hazard, inconvenience during transportation, the negative impact of freons on the ozone layer of the earth.

The paper presents the results of selecting an extractant for obtaining a thick extract from the roots and rhizomes of Inula helenium L. The stages of developing a technology for obtaining a spray for the mouth and throat with an antibacterial effect based on a thick extract of Inula helenium L. are shown. Preclinical trials confirmed the antibacterial activity of the drug based on Inula helenium L. and its low toxicity.

The methods and results of the study on the selection of groups of auxiliary components that provide optimal technological parameters for the spray are also presented. Physicochemical and technological properties of the obtained experimental samples of the spray were determined. Based on the results obtained, the most promising spray composition was selected for further research.

functions and responsibilities of nurses in a heart failure clinic, using the example of the Chronic heart failure unit at the The Heart Center of the University Medical Center Corporate Foundation.

Materials and methods. This study is based on the practical experience of managing patients in the chronic heart failure clinic, which has been operating since 2014. Retrospective data from 2022 – 2024 were used, including quantitative indicators, frequency of decompensations, therapy adherence, and participation in postoperative follow-up.

Results and discussion. From 2022 to 2024, more than 4,000 patients were consulted. The number of patients who achieved optimal pharmacotherapy was 765 in 2022, 1,153 in 2023, and 1,107 in the first 9 months of 2024. The implementation of remote monitoring and nurse-led self-management significantly reduced hospitalization rates and improved patient awareness. Key nursing responsibilities include monitoring, education, psychological support, and coordination of interdisciplinary care.

Conclusion. Outpatient management of patients with chronic heart failure requires an interdisciplinary approach, with nurses playing a central role. The effectiveness of care increases through the integration of digital technologies, educational programs, and personalized care pathways.

Introduction. Monitoring patient satisfaction in the primary health care system, given the high prevalence of circulatory system diseases, is an extremely important stage in the external and internal assessment of the quality of services provided.

Aim. Development and validation of a questionnaire to assess patient satisfaction with outpatient medical care in the primary health care system, as well as identification of key factors affecting satisfaction levels.

Materials and methods. The proposed questionnaire was developed based on the analysis of more than 100 international sources and has undergone multi-stage validation, including peer review by 12 experts in the field of public health and practical medicine. Reliability was assessed using the Cronbach's alpha coefficient to identify significant satisfaction factors, and a factor analysis was performed.

Results and discussion. Patient satisfaction directly affects treatment adherence and, consequently, clinical outcomes. The questionnaire demonstrated a high level of internal consistency (α=0.89), and the factor analysis confirmed the constructive validity of the questionnaire. The questionnaire takes into account the regional peculiarities of healthcare in Kazakhstan and can be used to optimize the work of multidisciplinary teams.

Conclusions. The developed questionnaire can become an important tool for improving the quality of outpatient care and increasing patient satisfaction.

Aim. To identify and analyze the main causes of conflicts in medical organizations between doctors and patients, explore their legal nature, and propose legal mechanisms for resolution.

Materials and methods. A cross-sectional study was conducted from January to February 2025 involving 148 respondents: 65 physicians from a multidisciplinary hospital and 83 patients. Participants completed a structured questionnaire.

Results and discussion. The study revealed key factors contributing to conflict situations in the medical field. According to the survey of doctors, 53.2% reported experiencing high levels of occupational stress. The main causes of conflict, from the medical staff is perspective, were rude and unethical patient behavior, misunderstanding of treatment approaches, and dissatisfaction with the quality of care.

Patients, in turn, pointed to insufficient information about their condition, long waiting times, and unsatisfactory hospital conditions. The findings indicate that poor communication between doctors and patients is a central factor, often leading to mistrust and anxiety among patients.

Conclusions. The study highlights the need to improve patient information, strengthen trust and the professional status of physicians, and implement thoughtful conflict resolution strategies in healthcare.

This paper presents a clinical case of orthotopic bicaval heart transplantation in a patient with end-stage chronic heart failure that developed against the background of peripartum cardiomyopathy. The disease manifested itself in the second trimester of pregnancy, complicated by severe preeclampsia and progressive heart failure. In the absence of an available donor organ, the patient was implanted with a left ventricular assist device HeartMate 3 as a «bridge to transplantation». Four years after left ventricular assist device implantation, when a donor appeared, orthotopic heart transplantation was successfully performed. The case demonstrates the effectiveness of a multidisciplinary approach in conditions of a limited donor resource and emphasizes the need for early diagnosis, systemic prevention and development of transplantation services to improve outcomes in patients with peripartum cardiomyopathy.

Penetrating injuries of the eyeball with penetrating foreign bodies are the most severe type of damage to the visual organ. Due to the prolonged stay of chemically active foreign bodies in the eye, siderosis and chalcosis may develop, prevention of which is early surgical intervention. The degree of severity of the pathological process should naturally be influenced by the size of the intraocular foreign body, its localisation and the period of stay in the eye.

The article presents a clinical case of removal of a magnetic foreign body that was in the anterior chamber of the eye for 16 years without an inflammatory reaction in its tissues.

In this clinical case, minimal phenomena of siderosis occurred from the side of the iris root at the site of the intraocular foreign body at 6 o'clock, which can be explained by the areactivity of the course as a result of localization in the corner of the anterior chamber, where, apparently, metabolic processes are more active and encapsulation of a foreign body that created a barrier for further entry of toxic products into the intraocular structures. But the very fact of the presence of a magnetic intraocular foreign body is not physiological for the organ of vision and the operation of removing a foreign body, regardless of the time that has passed after the injury, is the right decision.

The presence of an intraocular magnetic foreign body is an indication for its removal, despite the limitation period of the injury and the areactive course of the process.

Currently, an interdisciplinary comprehensive approach is widely practiced in medicine, which allows assessing the general condition of the patient, improves the quality of medical care. Orthodontic patients usually need a consultation with a pediatrician, ENT doctor, speech therapist. This approach forms a single algorithm for diagnosis and treatment, which helps to obtain positive results in a short time.

Aim – to apply an interdisciplinary comprehensive approach to the treatment of distal occlusion in a patient after adenotomy

We describe the experience of using an interdisciplinary comprehensive approach to the treatment of distal occlusion in a patient after surgery for adenoid hypertrophy. Diagnosis and treatment of the patient for dental diseases was carried out in this clinic, at the same time he was observed in other medical institutions on issues of providing pediatric and otolaryngological medical care, and underwent classes with a speech therapist.

The diagnostics showed the presence of myofunctional disorders - mouth breathing, infantile type of swallowing and tongue thrusting between the dental arches. We prescribed orthodontic hardware treatment to the patient, and taking into account the orthodontic diagnosis, the patient was referred for consultations to a pediatrician, ENT specialist, speech therapist. Using hardware orthodontic treatment, we achieved physiological closure of the teeth in the lateral sections of the dental arches and excluded myofunctional disorders in the patient. The otolaryngologist who observed the patient did not conclude that there was no relapse of adenoid hypertrophy. The pediatrician observed the patient for concomitant diseases, recommendations were given. The speech therapist - defectologist used myogymnastic exercises that helped eliminate myofunctional disorders.

Today, there are frequent cases of lack of comprehensive, structured plans for examination and further interaction between doctors of various profiles (orthodontist, otolaryngologist) and speech therapists, myofunctional therapists.

In such cases, time and resources are not used with maximum efficiency, and the risk of incomplete diagnosis of myofunctional disorders increases, which affects the overall result and quality of life. To eliminate the negative consequences of incomplete diagnosis and insufficient coordination in patient management, it is necessary to develop special methodological recommendations for an interdisciplinary comprehensive approach to the treatment of patients with ENT pathology, including after surgery for adenoid hypertrophy.