Objective. To study clinical features structure of post-COVID syndrome, and possibilities of stratification of subgroups of patients recovered from SARS COV-2 infection by severity.

Materials and methods. Study design: observational, cross-sectional.

In the period 2023-2024, 101 patients (44 men, 57 women; median age is 47.5 [41; 54] years old) with post-COVID syndrome (6-12 months after reconvalescentia) and 14 individuals in control group (4 men, 10 women; median age is 40 [28; 50] years old) were examined.

All patients underwent clinical, neurological and psychological examination, filled out a checklist to identify signs of post-COVID syndrome. Mini-Mental Status Examination (MMSE) scale and the Amatuni correction test were used to assess cognitive functions. Personal and reactive anxiety was determined using the Spielberger-Hanin questionnaire, subjective vegetative status - by filling out the A.M. Vein questionnaire.

The obtained data were processed in the STATISTICA 10.0 software package, using descriptive statistics, cluster analysis, the Mann-Whitney U-test, the Kruskal-Wallis H-test, and the χ2 test.

Results. An attempt to divide a group of post-COVID patients into two subgroups according to the checklis, based on the most common neurological complaints, revealed differences between subgroups in the state of cognitive functions according to MMSE, Amatuni test and muscle fatigue. Follow-up cluster analysis according to the checklist scores and MMSE made it possible to identify three subgroups, in which differences in the parameters studied were already more significant.

Boundary parameters for subdividing a group of post-COVID patients according to the checklist score are defined as: 1-3 points — a subgroup with mild disorders, 4-7 points — moderate severity, more than 8 points — heavy severity.

Conclusion. Clinical and neuropsychological analysis of the condition of post-COVID patients made it possible to identify three subgroups of patients with varying severity of disorders, and to form a diagnostic tool for their division. Further study of the resulting subgroups will help to optimize the study of pathogenetic mechanisms for the formation of long-term maladaptation.

Objective. To determine the prognostic value of cytomorphological characteristics of granulosa cells (GCs) in follicular fluid (FF) for assessing embryo implantation (EI) in in vitro fertilization (IVF).

Materials and methods. FF samples obtained during aspiration of oocyte-cumulus complexes for IVF due to infertility were studied. Studied groups (SG): SG1 – EI did not occur (n=61), SG2 – successful EI (n=54). The number of GCs in the preparations was counted, and the average nuclear diameter was measured. The expression of FSHR, ERβ, and PR proteins in GCs was assessed by immunocytochemical (ICC) method.

Results. Statistically significant differences were found between SG1 and SG2 in the expression intensity of FSHR (p=0,001), ERβ (p=0,031), and PR (p=0,024) proteins, the number of GCs in the preparations (p=0,005), and the average nuclear size of FF GCs (p=0,0001). ROC analysis showed that successful implantation was associated with the average nuclear size of GCs and the expression intensity of FSHR and ERβ, which had the best diagnostic sensitivity (86,4%, 78,6%, and 77,19%, respectively), specificity (77,4%, 80,95%, and 83,33%, respectively), and efficiency (81,9%, 79,78%, and 80,26%, respectively). A prognostic model was constructed using binary logistic regression. Considering the selection of the optimal threshold value of the resultant variable Y (0,610), diagnostic sensitivity (94,4%), diagnostic specificity (93,4%), and predictive value (93,9%) were achieved.

Conclusion. Potential predictors of successful EI in IVF were identified by studying the morphological characteristics and hormone receptor status of FF GCs. The developed prognostic model can be used to assess the probability of EI.

Objectives. To evaluate retrospectively the structure of malignant neoplasms in HIV-infected patients using the example of Svetlogorsk district, as the area with the highest prevalence of HIV infection in the Republic of Belarus.

Materials and methods. The data of patients living in Svetlogorsk district of Gomel region and registered in the Belarusian Cancer Registry from 2015 to 2022 were analyzed. A comparison of data of patients with malignant neoplasms was conducted in HIV-positive patients (HIV+) (97 people) and HIV-negative (HIV-) residents of Svetlogorsk region (3015 patients).

Results. Among the registered cases of cancer in HIV-infected patients, 32% were AIDS-associated neoplasms, 66% were AIDS-non-associated neoplasms. The most common neoplasms in HIV-infected patients were non-Hodgkin’s lymphoma, breast cancer, lung cancer, cervical cancer, Kaposi’s sarcoma, and oropharyngeal cancer.

Proportion of HIV-infected patients was 16.7% in the structure of malignant neoplasms in patients under the age of 50, but there was more than 60% among patients with non-Hodgkin’s lymphoma, and 30% among women with cervical cancer.

Conclusion. Developing of the screening program and prevention of the predominant cancers in HIV-infected patients of working age will make it possible to increase their life expectancy and life quality.

Objective. To develop a national high-sensitivity and marked specifity enzyme immunoassay test system for determining class М immunoglobulins to the hepatitis E virus (HEV) in human blood serum “ELISA-anti-HEV IgМ“.

Materials and methods. The base for this research is City Clinical Hospital of Infectious Diseases in Minsk. Qualitative determination of anti-HEV IgМ in human blood serum samples was carried out by indirect enzyme immunoassay using reference kits – “ELISA-ANTI-HEV-IgМ“, Vecto hep E-IgМ. 96-well polystyrol strip plates were used to design a national test system for the qualitative detection of anti-HЕV-IgМ; recombinant antigens – analogues of the protein ORF2 and ORF3 HЕV of the genotype 3; antibodies against human IgM conjugated with horseradish peroxidase; post-closing solution; serum dilution solution and conjugate dilution solution.

Results. Optimal concentrations for sorption of ORF2 and ORF3 proteins were determined, amounting to 2 mg/ml and 1 mg/ml. The incubation time with TMB is set to 20 minutes. Diagnostic sensitivity of the test system was no less than 99%, and diagnostic specificity was no less than 99%. The index of in-series reproducibility was 92,3%, inter-series reproducibility was 86,1%. Technical specifications TU BY 100185093.093-2023 were developed and registered. Direction for use of the reagent kit of the test system “ELISA-anti-HEV-IgM human“ for determining markers of acute viral hepatitis E in human blood serum by enzyme immunoassay was approved.

Conclusion. The first national test system “ELISA-anti-HЕV-IgM” for the determination of class M immunoglobulins against hepatitis E virus in human blood serum by indirect enzyme immunoassay was developed. Laboratory and technical tests of the experimental sample of the test system were carried out, shown its high diagnostic sensitivity, specificity and reproducibility. The regulatory, technical and operational documentation for the test system was approved. 

Objective. To develop a new composition of an antibacterial polymeric coating for modifying a woven vascular prosthesis in an experiment.

Materials and methods. Experimentally determined mechanical and antibacterial resistance, cellular and tissue reactions of modified woven vascular prostheses with a hydrogel coating from polyvinyl alcohol, polyvinylpyrrolidone, chitosan, hyaluronic acid and the antibiotic vancomycin (1%); samples of woven vascular prostheses with a hydrogel coating from polyvinyl alcohol, polyvinylpyrrolidone, chitosan, L-aspartic acid and an antibiotic Vancomycin (1%); samples of woven vascular prostheses with a hydrogel coating of polyvinyl alcohol, chitosan, L-aspartic acid and the antibiotic Vancomycin (1%).

Results. Evaluation of mechanical stability and evaluation of duration of antibacterial resistance of modifications revealed that the presence of L-aspartic acid inhances resistance to leaching of Vancomycin (1%) from the polyvinyl chitosan coating and increases the duration of antibacterial resistance of the prosthesis compared with hyaluronic acid from 4 to 5 days. Evaluation of cellular and tissue reactions shows that the addition of polyvinylpyrrolidone into a coating based on a polyvinyl-chitosan complex with L-aspartic acid reduces the rate of transformation of granulation tissue into coarse-fibrous connective tissue.

Conclusion. It was experimentally determined that the best tested antibacterial polymeric coating for modification of woven vascular prostheses is a combination of polyvinyl alcohol, chitosan, and L-aspartic acid after soaking in a 1% solution of Vancomycin for 30 minutes.

Objective. To evaluate the properties of various materials used for tamponade of the external auditory canal after surgery in an animal experiment by studying the separate indices of the general blood analysis and C-reactive protein (CRP).

Materials and methods. The article presents the results of the experiment using laboratory animals for studying comparative evaluation of the properties of cellulose as a material for tamponade of the external auditory canal with a gauze tampon, and a Merocel type tampon. The total of 36 chinchilla rabbits were used in the experiment. Analysis of individual indicators of the general blood test and CRP was carried out in the postoperative period.

Results. The experiment showed that there are no differences in the number and ratio of leukocytes of different populations and subpopulations in leukocytic formula in experimental and control groups of laboratory animals. Our studies did not reveal statistically significant differences in the amount of CRP as well.

Conclusion. The experimental results indicate the potential safety and biocompatibility of cellulose when used in clinical practice. Cellulose can be considered as a promising material for making a tampon used after middle ear surgery.

Objective. To compare the dynamics and duration of healing of full-thickness skin wounds under gauze and hydrogel dressings (Vap-Gel and HydroTac Transparent), as well as to evaluate their effect on the activity of immunocompetent cells and histological features of skin regeneration.

Materials and methods. Thirty-one female Wistar rats were used, and full-thickness skin defects were created in the interscapular region. Three groups received different dressings: gauze (control), Vap-Gel, and HydroTac Transparent. Healing was monitored for 20 days through wound measurements, histological analysis, and immunological studies. The data has been processed statistically.

Results. It was found that the Vap-Gel hydrogel particles were integrated into the granulation tissue. Immunological studies highlighted reduced neutrophil activity in Vap-Gel-treated wounds. Both of these features had no significant effect on the duration of wound healing. HydroTac Transparent caused slower epidermization compared to gauze. Histological analysis revealed alterations in epidermis thickness and granulation tissue structure among groups. The mean epidermal thickness on the wound surface was 20-30 percent thinner in the groups treated with hydrogel dressings compared to the control group (p <0.05).

Conclusion. It suggests that hydrogel dressings offer some advantages over traditional gauze in healing uninfected wounds. In general, the studied wound dressings provided a similar speed of the wound healing process. However, the observed changes in granulation tissue structure and local immune response suggest the need for further research to better understand the mechanisms of hydrogel dressings and optimize their application in wound care.

Objective. To assess reversion of tolerogenic dendritic cells (tolDC), obtained from human blood monocytes into immunogenic mature dendritic cells (mDC) under the influence of TNF-α.

Materials and methods. The immunophenotype of dendritic cells (DCs) obtained from blood monocytes of healthy donors (n=6) was assessed by flow cytometry: immature DC culture (immDC), mature (mDC) culture, tolDC culture, tolDC culture after exposure to the proinflammatory factor TNF-α (tol DCs/TNF-α). Statistical analysis was performed using nonparametric methods.

Results. There was 24.05(19.30-28.20) % of CD83+ cells in the population of mDCs, that was significantly higher compared with immDCs, tolDCs and tolDCs after stimulation with TNF-α (imm DCs – 4.10 (2.75-5.83), tol DCs – 4.45 (3.68-4.93), tol DCs/TNF-α – 9.70 (8.83-10.58). The intensity of HLA-DR expression on the surface of mDCs was significantly higher compared with immDCs, tolDCs and tolDCs after stimulation with TNF-α (imm DCs – 23.03 (18.24-25.40) RFI; tolDCs – 27.54 (25.04-32.41) RFI; tolDC – 10.56 (9.21-12.77) RFI; tolDC/TNF-α – 13.74 (10.66-18.53) RFI (RFI – relative fluorescence intensity).

Conclusion. Adding of the TNF-α as maturation inducer did not result in immunophenotypic reversion of tolDCs to the mDCs level. The obtained data indicate in favor of possibility to use safely tolDCs as a biomedical cell product for the treatment of diseases associated with an excessive immune response.

Objective. To assess the level of vitamin D in different seasonal periods in adults living in Gomel region.

Materials and methods. A retrospective analysis of serum vitamin D concentrations was performed for the period from 2023 till October 2024, taking into account the season of the year and the accepted interpretation of values.

Results. The frequency of clinically significant ranges of vitamin D concentrations in blood was determined on a sample of 11,276 adults, residents of Gomel region. The dependence of vitamin D values on the season of the year was established. The need for dietary adjustment of vitamin D levels both in summer, in addition to sufficient sun exposure, and during periods of insufficient insolation (winter, spring), while taking vitamin D preparations, was substantiated, that was proven by the high frequency of vitamin D deficiency in summer and the low frequency of detection of target values in winter and spring.

Conclusion. Detailing the distribution of clinically significant values of vitamin D depending on the season of the year allows us to supplement fundamental knowledge about the influence of climatic and geographical factors on human health and will have social and hygienic significance for organizing measures to prevent the formation of vitamin deficiency states. 

Objective. To assess the level of internet users’ interest in the Republic of Belarus in the topic of diabetes.

Materials and methods. An analysis of search queries containing keywords “diabetes,” “types of diabetes,” and “diabetes symptoms” was conducted in Yandex and Google search engines for the period from January 2020 to December 2024. Interest was evaluated based on the following indicators: the number of monthly impressions, relative number of impressions, and regional popularity index (affinity index). The data were obtained from analytical services performing anonymous collection and processing users query statistics.

Results. There has been a steady increase in the number of queries related to diabetes since 2021, that may indicate heightened interest to this issue. Moreover, the peak of search activity occurs in January and December of each year, which is due to seasonal increases in health-related concerns. In 2024, the absolute number of queries reached a record high of 25,052 impressions in December. The analysis of regional popularity conducted according to the data of Yandex search engine showed that the highest interest index was recorded in Grodno (104.0%) and Gomel (103.8%) regions, whereas Minsk and Minsk region had a lower index (94.4%). Google Trends data confirmed a similar trend, however highest interest in diabetes observed in Vitebsk region (100 points) in this search engine.

Conclusion. There has been a steady increase in public interest in diabetes in Belarus over the past five years. The number of search queries has doubled, highlighting the need of users for information on the disease and its prevention. Availability of online consultations, development of telemedicine and mobile applications may enhance public awareness, and improve the quality of diabetes prevention and treatment. Seasonal fluctuations in interest confirm the need for a flexible approach for providing medical information and services, particularly during periods of increased demand. 

Objective. To assess efficacy of the social and hygienic monitoring system based on determining the level of satisfaction of medical workers with the organization of its activities for patients with bronchial asthma and patients at risk of developing bronchial asthma.

Materials and methods. The study used sociological and statistical research methods. The assessment of respondents’ satisfaction, which characterizes the efficacy of social and hygienic monitoring, is based on analysis of 6 blocks. The research volume consisted of 403 respondents. Statistical analysis of the data obtained was carried out using parametric and nonparametric research methods, descriptive statistics methods, and reliability assessments. Statistical data processing was carried out using the Statistical 10 software package.

Results. The majority of respondents believe that the most important measures for social and hygienic monitoring of the health of a patient with bronchial asthma are “identification of risk factors for bronchial asthma”, “organization of monitoring of the patient’s health” and “identification of environmental factors that have a harmful effect on the patient”, the least important measures are “interaction between healthcare organizations and centers hygiene and epidemiology” and “database maintenance”.

The low level of satisfaction of respondents with the social and hygienic monitoring of bronchial asthma was specified based on the fact that a significant part of respondents rated the organization of activities included in 6 blocks as “below average”, the proportion of which ranged from 26% to 41.3%.

The analysis of the correspondence of the actual level to the maximum level of satisfaction with the organization of social and hygienic monitoring of asthma showed that the maximum level of satisfaction was not achieved both in general and in individual blocks, and indicated a low efficiency of the implementation of this process.

Conclusion. Importance rating of social and hygienic monitoring measures which affects formation of the level of satisfaction and assessment of effectiveness of implementation of this process was determined.

Objective. To assess the awareness of healthcare professionals about suicide prevention.

Materials and methods. A survey of managers, general practitioners, and medical specialists of Gomel region was conducted on the topic of “Organizational and medical barriers in providing medical care to the population for the prevention of suicides (SU)”. Respondents were also asked to provide recommendations and suggestions for improving SU prevention measures at the level of healthcare organizations, at the district (city) and regional levels of medical care.

Results. The conducted study made it possible to determine the presence of barriers in provision of medical care to the population for the prevention of SU.

More than half of the respondents (255 (51,93 %) people) noted that the presence of suicidal thoughts is a very rare phenomenon, in 344 (70,06 %) responses the respondents assumed that if someone wants to kill themselves, they do not talk about it. 241 (49,08 %) doctors believe that people talk about possible self-inflicted harm only to attract attention. A significant majority of specialists (442 (90,02 %)) indicated that people who attempt SU often have a serious sense of hopelessness and isolation and are unwilling to discuss their suicidal thoughts.

Two thirds of respondents (327 (66,60 %)) assumed the annual mortality rate from SU in the world to be about 4,5 per 100000 of population. Opinions regarding the frequency of SU attempts by gender divided approximately equally. Thus, only 290 (59,06 %) respondents noted that SU attempts are more frequent among men than women.

Conclusion. The studied data indicate low awareness of health workers on the prevalence of suicidal activity among the population. However, sufficient awareness of doctors on the characteristics of suicidal behavior, suicidal thinking, actions, motives and conditions for committing SU was revealed. This determines the need to strengthen educational programs aimed at raising the awareness of specialists.

Objective. To substantiate the effectiveness of a set of measures to improve the provision of assistance in suicide (SU) prevention.

Materials and methods. The legislative acts of the Ministry of Health of the Republic of Belarus, the Main Healthcare Department of Gomel Regional Executive Committee on issues of work organizations of institutions involved in SU prevention were studied. The emphasis was made on the features of interdepartmental interaction of prevention entities when analyzing regulatory and legal acts. Data analysis was performed using the R programming language (version 4.5.0). Trend modeling, forecasting, and assessment of the effect of SU prevention interventions were performed using linear regression analysis. Relative indicators were calculated per 100,000 population.

Results. An algorithm for improving provision of assistance in prevention of SU is proposed based on the analysis of a comprehensive plan for the prevention of suicidal behavior of the population by region; an algorithm for interdepartmental analysis of cases of death from suicide, as well as cases of death from external causes with signs of suicide of the Gomel Regional Executive Committee; repealed order “On measures to optimize suicide prevention in the Gomel region”; methods for screening for SU risk (Ask Suicide-Screening Questions) within the order of the Minister of Health dated 26.02.2025 No. 194 “On assessing SU risk”.

Conclusion. The proposed algorithm for improving the provision of assistance in suicide prevention can contribute to a further reduction in the SU rate and achievement of the target indicator. It is also planned to exceed the target indicator for the organization and provision of assistance to healthcare organizations in the implementation of task 2 “Protection of mental health and reduction of the SU rate” of Subprogram 3 “Prevention and overcoming of drunkenness and alcoholism, protection of mental health” in accordance with the State Program “Health of the People and Demographic Security of the Republic of Belarus” for 2021-2025.

Objective. Demonstration of a clinical case of adrenal adenoma with mixed hormonal secretion.

Materials and methods. Retrospective analysis of the medical history of a patient who was hospitalized in the endocrinology department of the Republican Scientific and Practical Center for Radiation Medicine and Human Ecology.

Results. Endocrine arterial hypertension is a current problem of modern endocrinology. The majority of the arterial hypertension data is attributable to primary hyperaldosteronism, represented by adenoma or bilateral adrenal hyperplasia. Diagnosis of these conditions presents difficulties, requiring confirmation of the presence of a volumetric formation according to instrumental diagnostics, as well as laboratory confirmation of its hormonal activity. A clinician may find rare features indicating mixed hormonal secretion of benign adrenal lesions during the study,

Conclusion. Primary hyperaldosteronism and endogenous hypercortisolism are common causes of the development of secondary hypertension, which worsen patients’ quality of life and increase the risks of mortality and disability. The occurrence of adenomas with mixed secretion is extremely rare in endocrine practice, which does not affect the further management of patients, but poses special difficulties for diagnosis.

Toxocariasis is a widespread disease caused by larvae of Toxocara canis and Toxocara mystax, characterized by a long recurrent course and multi-organ lesions. Clinical manifestations of toxocariasis in children do not have their specific features. Taking into account variety of clinical manifestations of the disease, in some cases its diagnostics presents challenges. The main role in determination of the diagnosis belongs to laboratory diagnostic methods.

The article considers a clinical case of Visceral toxocariasis in a child with recontamination, and difficulties in diagnostic search and diagnosis verification.

The article presents a case of multiple myeloma with minimal laboratory changes, which hindered timely diagnosis. The features of clinical manifestations and diagnostic challenges during the patient’s examination stages are described.

Objective. To develop an Intelligent System (IS) for foreign students preparation for surgery exams to confirm diplomas obtained in foreign medical universities.

Materials and methods. Development of the system consisted of two stages: 1) creation of a Decentralized Knowledge Graph (DKG); 2) integration of DKG with the technology of Large Language Models (LLM), digital twins and a chat-bot. The materials for the developed IS were structured data: textbooks on surgery, which are used for preparation of postgraduate examinations in India (FMGE), educational materials of the Department of Surgical Diseases No. 3 of the Gomel State Medical University, web pages https://cyb.ai/@gsmu-by/brain.

Results. The created IS is deployed on a local server/computer and includes the DeepSeek LLM, a chatbot on the AnythingLLM platform and Telegram; it works on the RAG technology (Retrieval-Augmented Generation), which combines information search and text generation based on the found data. The IS was tested during surgery classes with foreign fourth year students of the Gomel State Medical University.

Conclusion. The developed information system for preparation for postgraduate examinations in surgery allows better personalization of training and can improve the efficiency of preparing students for postgraduate examinations in their home countries.

Objective. To characterize the intestinal microbial diversity in patients with chronic hepatitis C virus infection, depending on the HCV genotype.

Materials and methods. A cohort single-center study of 41 patients with chronic HCV infection (32 people with chronic viral hepatitis C and 9 people with liver cirrhosis of viral C etiology) was conducted, within which the intestinal microbiota profile was determined by the method of metagenomic sequencing of 16S rRNA. High-throughput sequencing was performed using the MiSeq genetic analyzer (Illumina, USA) using a protocol based on the analysis of variable regions of the 16S rRNA gene. The data were analyzed using the Kraken2 algorithm. The significance level was taken to be 0.05.

Results. The microbial diversity of the intestines of patients with HCV has been characterized depending on the HCV genotype. Differences in the abundance of Actinomycetota and Verrucomicrobiota have been established at the type level. A number of Actinomycetota in patients with HCV genotype 3 was more than 3 times higher than in patients with HCV genotype 1. The Verrucomicrobiota type was significantly higher in patients with HCV genotype 1 than in patients with HCV genotype 3. At the class level, significant differences were found in the abundance of Actinomycetia, Verrucomicrobiia, Bacteroidia, Mollicutes, and Gammaproteobacteria. Significant changes at the family and genus levels are described.

Conclusion. For the first time, microbial diversity of the intestine in patients with chronic hepatitis C virus infection has been characterized depending on the HCV genotype. Further research will help to better understand the pathogenetic mechanisms of HCV infection, which will contribute to the development of personalized approaches in the treatment of patients with chronic viral liver disease.