PROCEEDINGS OF THE SECOND INTERNATIONAL SCIENTIFIC – PRACTICAL VIRTUAL CONFERENCE ’’MODERN MEDICINE: PROBLEMS, PROGNOSES AND SOLUTIONS’’

s and Theses ................................................................. .................................................... 10

Emails: 1 gmzh@list.ru, 2 micropaleontolog@yandex.kz, 3 humana-west@mail.ru, 4 eleonora_71@bk.ru, 5 baikadamovalyazat@gmail.com BACKGROUND Hyperphenylalaninemia (HPA) is a group of autosomal recessive diseases caused by impaired metabolism of the essential amino acid phenylalanine (Phe), which enters the human body with protein food [1]. HFA combines several genetically heterogeneous forms of phenylalanine metabolism disorders similar in clinical features: classical phenylketonuria (PKU), caused by phenylalanine-4-hydroxylase (PAH) deficiency and hyperphenylalaninemia (HPA), associated with tetrahydrobiopterin (BH4) metabolic disorders [2]. The pterin-dependent form of hyperphenylalaninemia accounts for about 2% of all cases of HPA. These conditions are caused by a deficiency of enzymes involved in the synthesis or reduction of tetrahydrobiopterin (BH4), which is a PAH cofactor, as well as tyrosine hydroxylase and tryptophan hydroxylase [3,4]. Currently, several genetically heterogeneous forms of BH4-deficient HPA are known: type A, 6-pyruvoyltetrahydropterine synthase (PTPS) deficiency, type B, guanosine triphosphate cyclohydrolase 1 (GTPCH) deficiency, type C, dihydropterine reductase (DHPR) deficiency, type D, pterin-4a-α-carbinolamine dehydratase (PCBD) deficiency, DOPA-dependent dystonia caused by sepiapterin reductase (SPR) deficiency and HPA without tetrahydrobiopterin deficiency, caused by mutations in the DNAJC12 gene encoding the JDP1 protein [5,6]. Pterin-dependent forms of HPA have clinical manifestations similar to classical PKU. In these forms, the main role in the pathogenesis is played by a severe deficiency in the neurotransmitters of the catecholamine and serotonin series, which makes isolated diet therapy meaningless and requires different approaches to treatment. The complex of treatment for such patients includes BH4 or its synthetic analogs [3][4][5]. Clinical case. Child A., a boy, was admitted to the clinic at the age of 11 months due to a pronounced delay in psychomotor development. From the anamnesis: the child from the second pregnancy, the pregnancy was uneventful, was born on time with a weight of 3240 g, a length of 54 cm. The parents are not consanguineous, they are healthy. They have one healthy child. During the examination under the program of mass screening of newborns, A. was diagnosed with hyperphenylalaninemia. The level of phenylalanine in the blood was 940 μmol / L. Based on this, he was diagnosed with phenylketonuria and prescribed diet therapy with restriction of protein intake. With strict adherence to a low-protein diet, the level of phenylalanine in the blood during the first two months of life decreased insignificantly, to 610 μmol / L, and then decreased to normal values, 75-100 μmol / L. Upon admission to the clinic, there is a deficiency of body weight and height, moderately pronounced microcranium, light hair color. Neurological status: symptoms of muscular dystonia are determined -moderate hypotonia of the trunk muscles and hypertonicity of the muscles of the extremities, tendon reflexes are increased. When the position of the body changes, there is an increase in muscle tone, tremor, and oculogyric crises. Poorly holds the head, does not turn on the stomach, grabs the toy and holds it for a short time. In the clinical analysis of blood and urine pathological changes were not revealed. In the study of the concentration of amino acids in the blood by tandem mass spectrometry, the level of phenylalanine was 102 μmol / L. The lack of positive dynamics in the psychomotor development of the child while following a low-protein diet, which ensures the maintenance of a normal level of phenylalanine in the blood, made one suspect a cofactor form of hyperphenylalaninemia. In order to diagnose BH4 -deficient HPA, a sensitivity test to sapropterin dihydrochloride was carried out, which gave a positive result. The patient is recommended to undergo a molecular genetic study -sequencing of the PTS, QDPR, GCH1, PCBD, SPR, DNAJC12 genes to determine the specific type of BH4 -deficient HPA. Keywords: PTS, QDPR, GCH1, PCBD, SPR, DNAJC12 genes, BH4 -deficient HPA

INTRODUCTION
Complications of diabetes mellitus (DM) are of great medical and social importance, as they cause severe disability and premature death of patients with diabetes mellitus. Bone remodeling disorders occurring in diabetes increase the risk of fractures and move the problem of diabetic osteopathy beyond the narrow specialty, making it the subject of extensive scientific research [1][2][3]. However, osteopathy remains an underestimated complication and is not considered in most diabetes guidelines. The fact that diabetic osteopathy is often asymptomatic leads to the fact that diabetic patients turn their attention to this pathology late and turn to a specialist, as a rule, already having a high degree of progression of this complication. One of the important issues is the timely detection and prediction of bone changes in diabetes mellitus. The introduction of artificial intelligence technologies (AIT) into clinical practice is one of the main trends in world medicine [4]. AIT and Artificial Neural Networks (ANN) can fundamentally change the criteria for diagnosis and prognosis, which will contribute to the development of new therapeutic approaches, improve the efficiency of medical care and reduce costs [5]. The prospects for using ANN can potentially provide almost limitless technical possibilities. Considering the possibilities of using these technologies in clinical practice, we came to the conclusion that the development and implementation of forecasting systems based on the construction of a model of an intelligent decision support system based on the apparatus of artificial neural networks is able to analyze clinical and laboratory indicators of patients with diabetes mellitus (DM) in order to predict the values of qualitative and quantitative indicators assessing the state of bone tissue.

PATIENTS AND METHODS
The research was conducted from November 2015 to July 2017. A cross-sectional study evaluating the data of 98 patients with type 1 diabetes (female: 57, male: 41) and 137 patients with type 2 diabetes (female: 85, male: 52) aged from 40 to 69 years, who have not previously been diagnosed with bone metabolism disorders and osteoporosis was evaluated. Exclusion

THE SECOND INTERNATIONAL SCIENTIFIC -PRACTICAL VIRTUAL CONFERENCE -MODERN MEDICINE: PROBLEMS, PROGNOSES AND SOLUTIONS
criteria: persons previously treated for osteoporosis or having a history of fracture, as well as patients with diseases of the endocrine system, liver and kidneys of a non-diabetic nature, with a history of stage 4-5 diabetic nephropathy. The state of bone formation was judged by the activity of total alkaline phosphatase (ALP) and the content of the aminoterminal propeptide collagen type I (PINP) in blood serum. The level of bone resorption was judged by the content of the C-terminal telopeptide (b-CTx). All patients underwent dual-energy X-ray absorptiometry (DXA) of the lumbar spine (L1-L4) to measure bone mineral density (BMD). The relationship between the results of laboratory studies and the parameters of bone metabolism was revealed when analyzing the results of this study.The study of the above patient data gave the researchers a list of 30 variables, including the BMD value for each of the patients, which were used to develop of ANN model. All of the variables considered, according to previous medical studies, have an impact on the diagnostic and prognosis of osteoporosis. The construction of the neural network was carried out using MATLAB 8.6 (R2015b) [6].

RESULTS
The practical effect of the constructed Artificial neural network model for predicting BMD and values of bone remodeling markers in diabetes based on the analysis of a number of laboratory pa-rameters has been proved. The topology of the model consisted of an input layer, a hidden layer, and an output layer. A model with final ANN parameters was trained using data from 80% of patients from a randomly selected database. Data from the remaining 20% of patients were used to verify the results. As a result of the measurement of the absolute error average value, some adjust-ments were made to the model settings to increase its adequacy. Further training is achieved during its practical operation. The learning process continued until errors were reduced for all examples and stopped at the moment when the error in the control sample began to increase. For ease of use, a visual interface was created. Comparative analysis of this approach showed that the values obtained using the neural network diagnostic model reproduce the clinical research picture with a high degree of adequacy, which allows building a diagnostic algorithm for stratification impaired bone metabolism in diabetes.

CONCLUSION
The constructed neural network model is capable of predicting BMD and values of bone remodeling markers in patients with diabetes mellitus in accordance with the results of their laboratory analyzes. This model can be used to determine which patients should undergo densitometry and analysis of bone remodeling markers to check bone quality and prevent some of the risks associated with osteoporosis. Keywords: Artificial Neural Network, diabetes, reparative osteogenesis _________________________________________________________________________________________________

THE SECOND INTERNATIONAL SCIENTIFIC -PRACTICAL VIRTUAL CONFERENCE -MODERN MEDICINE: PROBLEMS, PROGNOSES AND SOLUTIONS
All patients were of Azerbaijan origin, from the Mediterranean region of Azerbaijan. They were evaluated for clinical findings and family history of FMF. Seven mutations of MEFV gene were identified in heterozygous, homozygous and compound conditions: R761H M694I, M694V, V726A, R202Q, M680I and E148Q. The mutations E148Q and R202Q were discovered in exon 2 and R761H M694I, M694V, V726A, M680I were found in exon10 in the population of the Republic of Azerbaijan. Three of 18 examined patients were heterozygotes, eight homozygotes, and seven double heterozygotes (compounds). Two mutations R202Q and E148Q were found in exon 2 (28.57%) of the MEFV gene, but the remaining five mutations, M860I, R761H, M694I, M694V and V726A were located in the exon 10 of the gene (71.43%). R202Q mutation was found in two heterozygous patients, mutation E148Q was heterozygous in one patient and as compound in two patients (R202Q /E148Q). The homozygous form of R761H mutation was registered in four cases, and M694I mutation in two persons in compound state (R761H / M694I). M680I mutation was identified to be homozygous in two patients (M680I / M680I). The M694I mutation was found in compound state separately with two other mutations as M694V and R202Q (M694I/ M694V and M694I / R202Q). The mutation of the V726A was identified as homozygous in three cases. It should be noted, that patients with homozygous form of mutations had parents in consanguineous marriages. The highest gene frequency of the MEFV gene examined in 18 patients was 27.3% which belongs to R761H mutation. The second place takes mutation V726A (18.2%), and M694I (15.2%) stands in the third place. To prevent the hereditary disease of the Family of Mediterranean Fever, parents of 18 patients were invited to the consultation of physician-genetics. Parents have got information about a healthy child prognosis for the next pregnancy. When the inheritance type is autosomal-recessive, it has been reported that the risk of a childbirth in the next pregnancy is 25%. As the majority of families are in reproductive age, they are preparing for the prenatal diagnosis of the fetus in the next pregnancy with their consent. Keywords: gene, population, sequencing, nucleotide, amplification, exon _________________________________________________________________________________________________

Introduction.
In the Republic of Azerbaijan in the period 2009-2019 years for the implementation of large-scale measures for the dynamic development of healthcare, decrees were signed on the approval of the State Program for the implementation of the development of the National Strategy in this, mainly, this is strengthening the material and technical base of medical institutions, the use of modern methods of examination and treatment, improving the quality of medical and pharmaceutical services to the population, state regulation of prices for essential medicines, training and improvement of personnel, introduction of compulsory health insurance.
Goal. The purpose of this work was to study the new economic foundations of financing the healthcare system in Azerbaijan, analyze the reforms in healthcare and the pharmaceutical sector, and apply them in practice. To achieve this goal, a number of local regulatory laws, as well as the activities of medical and pharmaceutical services to the population, were studied.
Discussion. During this period, our country has taken extensive measures to solve problems in the field of healthcare and the pharmaceutical sector. The regulatory legal acts governing pharmaceutical activities have been approved. In particular, state regulation of prices in the sphere of circulation of medicines has been introduced to prevent unjustified increases, as well as the application of measures of liability provided for by the legislation of the Republic of Azerbaijan for violation of the pricing procedure for medicines included in the list of essential medicines. In accordance with international standards, the quality control of medicines has been strengthened, the rules for issuing medicines have been improved, new prescription forms have been introduced, and admission to doctors is monitored. Email: ninopirtskhelani@yahoo.com, nkochiashvili@yahoo.com, ketikartvelishvili@yahoo.com leo_makh@yahoo.com COVID-19, which is caused by severe acute respiratory syndrome coronarvirus 2 (SARS-CoV-2), has spread across the globe. Although most patients recover within 1 to 3 weeks, COVID-19 has already caused >1 500 000 deaths all over the world. SARS-CoV-2 enters cells by binding to the angiotensin-converting enzyme 2 receptor, which is expressed on respiratory epithelial cells and other cell types, including endothelial cells. Unchecked viral replication induces a florid host response characterized by dysregulation of inflammation and coagulation. Dysregulation of coagulation produces a coagulopathy associated with hypercoagulability as evidenced by venous and arterial thrombosis and multiorgan dysfunction. Up to 20% of affected patients require hospitalization, and the mortality rate in such patients is high. The coagulopathy associated with COVID-19 is characterized by mild thrombocytopenia, slight prolongation of the prothrombin time, high levels of D-dimer, and elevated levels of fibrinogen, factor VIII, and von Willebrand factor. The levels of D-dimer, a breakdown product of cross-linked fibrin, correlate with disease severity and predict the risk of thrombosis, the need for ventilatory support, and mortality [1]. Novel coronavirus pneumonia (NCP) (COVID-19) is a disease caused by the enveloped viral pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). NCP, which is a major health problem worldwide, still has no definitive treatment or vaccine. Acute respiratory distress syndrome (ARDS) and sepsis are the main complications of the disease [2]. Additionally, disseminated intravascular coagulation (DIC) is one of the main underlying causes of death among patients [1]. A high number of thrombotic complications exist, and the incidence of thrombotic disease in individuals affected by NCP is reported to be 31% [3]. The brain and lungs were affected by the hypercoagulable state, and anticoagulant therapy should be started in these NCP patients [4]. Although the underlying pulmonary pathophysiology remains incompletely understood, severe COVID-19 infection is associated with a marked alveolar inflammatory cell infiltrate, together with a systemic cytokine storm response [5]. Several studies have also reported evidence of a COVID-19 associated coagulopathy [6,7,8]. Furthermore, multivariate regression analysis in Chinese COVID-19 cohorts reported that elevated plasma levels of fibrin degradation D-dimers constituted an independent biomarker for poor prognosis in . Consistent with the hypothesis that coagulation activation may play a role in COVID-19 pathogenesis, post-mortem studies have highlighted marked pathological changes specifically involving the lung microvasculature, including disseminated micro-thrombi and significant hemorrhagic necrosis [9,10]. Moreover, emerging data suggest that severe COVID-19 is also associated with a significant increased risk for developing deep vein thrombosis and pulmonary embolism [11,12]. Inherited thrombophilia is a genetic disorder of blood coagulation resulting in a hypercoagulable state, which has been suggested as a possible cause of recurrent thromboembolism. Family and twin studies have established a heritable component to venous and arterial thrombosis. For the vast majority of patients, thrombosis is a complex, multifactorial disease caused by a combination of numerous, often unknown, environmental and genetic factors [13]. The aim of this study was to analyze how important is to perform genetic testing for detection the intensity of connection between inherited thrombophilia (Factor V Leiden, Prothrombin G20210A and MTHFR C677T gene mutations) and the incidence of thrombotic disease in individuals affected by NCP. _________________________________________________________________________________________________ immunosuppresive state, caused by malignant neoplasms and directly by antitumor therapy. It is obvious that the anticancer problem of treatment and prevention of secondary infections in these conditions becomes even more urgent than before. Objective: To analise infections complications (IC) caused by microorganisms depending on antitumor treatment in cancer patients.

Materials and methods:
The study included 41 (100%) cancer patients with infectious complications during antitumor treatment in the Azerbaijan Medical University (AMU) Cancer clinic for skin and soft tissue neoplasms. Most often, the pathological process was lokalized in the lower extremities in 19 (46%) patients; in the upper extremities in 14 (34,1%) patients: in the trunk in 8 (19,5%) patients. Of these 12 patients (29,2%) patients received treatment for posteopertive complicattions, 10 (24%) patients received treatment for complicationsrelated to chemotherapy and 19 (46%) patients received treatmentrelated to radiation therapy. There were 28 (68%) men and 13 woman (36,5%) patients. The age of the patients ranged from 34 to 82 years among the studied patients with soft tissue tumors 24 (58%), skin tumors 17 (41,4%) patients . Results and discussions: for postoperative complications, the patients were divided by severity: uncomplicated -12 (100%) patients (mostly superficial, not reguiring extensive surgical interventios) and complicated-0 patients-(involving superficial and deep structures, often requiring extensive surgical interventions). Early diagnosis of infectious complications in patients with this pathology, the appointment of adequate regimens of antibiotic prophylaxis and therapy contribute to reducing the level of mortality from infection in this category of patients, and the expanding possibilities of specific antitumor treatment. _________________________________________________________________________________________________
2 PhD student of 2 nd course, Department of normal and topographic anatomy with operative surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
Email: 1 gzhurabekova@gmail.com, 2 aliyevamerey7@gmail.com Background: Sphenoid sinus (SS) is separated by a septum with various position, therefore sizes of two sinus cavities are variable [2]. In addition, sphenoid sinus differs in pneumatization type, ranging from its absence to extensive forms.Knowledge of the linear size and shape of the skull, the structure of the sphenoid sinus and its interconnection with nearby structures will help to avoid complications when performing surgical endoscopic interventions in the chiasmal-sellar region. Currently, the transsphenoid approach is the most optimal in neurosurgery for intracellar and cranial pathologies treatment. Due to proximity and anatomical interconnection of sphenoid sinus with other anatomical structures, such as anterior knees of intracavernous segments of internal carotid artery (ICA), optic nerve (ON), there is a high risk of complications during surgery [1,2,3,4]. Purpose: Features of skull craniometric parameters, the type sphenoid sinus pneumatization, and its practical value in various ON and ICA positions. Methods: The retrospective research, using magnetic resonance imaging (MRI) scans of head, included 1111 people, with 410 males and 701 females out of them but the scope of the article is limited to 93 of them, including 34 males (37%) and 59 females (63%) aged from 20 to 71 years. The research design complies with the Helsinki Declaration's provisions and was approved by the Local Ethics Committee of the West Kazakhstan Medical University named after Marat Ospanov №50 from January 17, 2020. The average age of males was 41.6 (20 -71 years), and for females was 41.7 (20 -66 years). Inclusion criteria were as the following: 1) age range from 20 to 71 years, 2) patients living in Aktobe region, 3) patients sent for examination with pituitary (hypophysis) pathology, 5) patients referred with CSR vascular pathology, 6) patients referred for verification of CSR pathology diagnosis. Exclusion criteria were as the following: 1) patients with skull bones fractures, 2) patients after skull trepanation, 3) patients having orthodontic and orthognathic research at examination time, 4) patients with congenital skull malformations, having gross skull deformation, 5) patients with brain tumors and hemorrhages with obvious CSR compression at examination time, 6) pregnancy, lactation, long-term use of hormonal drugs by persons of both gender. With the RadiAnt Dicom Viewer 5.5.1 program measured craniological indices: crosslongitudinal skull index, degree of pneumatization of the sphenoidal sinus; protrusion and/or gaping of internal carotid artery canal and optic nerve.Allstatistical analyses were performed using Statistica 8.0. Results: The data we obtained show that the vast majority of older males (60-80 years old) had mesocrane skull shape, in contrast to females, among whom the frequency of brachycrane skull shape prevails. Among 20-40 years aged males, the highest percentage falls on mesocrane skull form, while in females the frequencies of mesocrane and brachycrane skull forms are relatively the same. In males and females with ages of 40-60 years, mesocrane and brachycranean skull forms

THE SECOND INTERNATIONAL SCIENTIFIC -PRACTICAL VIRTUAL CONFERENCE -MODERN MEDICINE: PROBLEMS, PROGNOSES AND SOLUTIONS
are almost half of the total number of cases. An interesting fact was that dolichocranous skull shape is absolutely not found in both males and females of 40-80 years old age. The skull structure distribution by gender. Based on the sphenoid sinus types classification by Ossama & Guldner, our research revealed that there is no Conchal type (type I) in both genders. In 20-40 age, type III prevailed among males, while type IV has a maximum among females. Types III and IV predominated among males and females of 40-60 years old age. In 60-80 years category, type III prevails among females, while males have two times less. Type II is absent among 40-60 aged males and 60-80 aged females. As per the research of anatomical structures close to SS, it was found that ON and ICA canals form protrusions on the inner surface of the sphenoid sinus sidewall. The protrusion degree was ranged from a slight depression on the lateral wall to a complete "immersion" of canals into the sinus. No protrusion of ON and ICA canals were found in 60-80 years old males in 80% of cases, while complete absence of protrusion was shown in case of the same age females. However, protrusion of only the ICA canal occurs in 60% of cases with over 60 years old age females, while the same was in only 20% with the same age males. There was no case of ON canal protrusion in males, but ON canal gave a protrusion in sphenoid sinus wall in 49% of 20-40 years old females. ON and ICA canals protrusion in 20-60 years old males was found in about 30%, and the same protrusion was found in 60-80 years old females in 40%. Conclusions: This study is aimed at identifying the features of structure of the sphenoidal sinus, focusing on the absence of a dolichocrane type of skull among the population, on the clear distinction between men and women by the type of skull structure and the features of pneumatization of the sphenoidal sinus. The presellar type of sphenoidal sinus has a virtually low adherence to changes in sinus canals in types II and IV. Thus, careful planning of trans-sphenoid access to the sella is possible with modern imaging methods. Different anatomical variations can be detected so that problems can be predicted to be assessable. In order to avoid morbid consequences during surgery, it is imperative that clinicians determine the location and extent of sphenoid sinus walls and its relation to adjacent vital structures whenever trans-sphenoid pituitary surgery is expected. The few surgical tips related to sphenoid sinus anatomical configuration are important to keep in mind during such an approach. Keywords: MRI; sphenoid sinus; pneumatization; internal carotid artery; optic nerve. _________________________________________________________________________________________________

MORPHOFUNCTIONAL CHARACTERISTICS OF THE THYMUS IN SEVEN OLD RATS UNDER CONDITIONS OF MOUNTAIN HYPOXIA IN KYRGYZSTAN
Abaeva Tamara Suranalievna Kyrgyz state medical academy named after I. K. Akhunbaev.Bishkek. Kyrgyzstan Annotation. In recent years, the problem of hypoxia has attracted more and more attention of experimenters and clinicians, as the study of various aspects of hypoxia has shown the universal role of short-term or longer-term effects of oxygen deficiency in the regulation of the body's activity and the development of pathology. The most populated regions are those located in the low mountains (from 200 to 1400 m above sea level) and the middle mountains (from 1400 to 2500 m). The high mountains fall at a height of up to 3200 m. Currently, there is no doubt that the immune system also plays a certain role in the complex response of the human and animal bodies to the effect of hypoxia. In this regard, it can be stated that the immunology of the adaptation process and the study of its mechanisms in hypoxia is one of the main tasks of environmental immunology, the subject of which is the study of changes in immunoreactivity under the influence of environmental factors. The aim of this study is to study the morphofunctional structures of the thymus gland in seven -month-old rats . Material and methods of research: the histology of the thymus was studied in 60 seven-month-old rats living in various ecological and climatic conditions of kyrgyzstan. 1.anatomical methods (preparation). under the binocular magnifier mbs-2, the thymus was isolated and purified from surrounding tissues.2. Histological methods (hemotoxylin-eosin staining, according to Van Gieson). The results and discussion. It was established during the autopsy that the thymus in seven month-old rats is small in size, soft in consistency, its surface is lobed .The thymus gland is a small organ of pinkish-gray color, soft consistency, its surface is lobed. The cortical layer contains a large number of lymphoid cells, located very closely. On the periphery of the cortical layer, under the capsule, there are lymphoblasts. There are also many lymphoid elements in the brain layer, but much less than in the cortical layer. There is blood in the medullar layer between the cellular elements. In some places in the cortical substance there are epithelial-like cells and Gassal bodies. The number of the latter is not greater than normal. There is no Gassal at all in individual lobules of thymus. Bishkek in low-mountains conditions, i.e. 770 m above sea level, all indicators of the control group are within the normal range. Indicators in Bishkek it was established, lymphoblasts on average make 14,5 ±0,4; average lymphocytes 13,3 ±0,3; small lymphocytes 166,4 ±1,1; apoptotic bodies 77,8± 0,5; Mitoses 12,4± 0,3; Gassal corpuscles 1,7± 0,2. Stereometric characteristic of the thymus in three month-old rats shows: cortical substance 41,1 ±0,4, medullary substance makes 24,7 ±0,3. Intra-lobular perivascular space (VPP) 12,3± 0.3.interlobular septa is 22.8 ±0.4. In high-mountains conditions (3200 m above sea level), a noticeable change in cells, for example, the number of lymphoblast counts increased by 3.44%, medium lymphocytes increased by 2.03%, small lymphocytes by 316.8%. Apoptotic bodies 59.8%, mitoses 2.1%, Gassal corpuscles increased by 0.09%. Exponent macrophages increased by 0.12%. Stereometric

THE SECOND INTERNATIONAL SCIENTIFIC -PRACTICAL VIRTUAL CONFERENCE -MODERN MEDICINE: PROBLEMS, PROGNOSES AND SOLUTIONS
characteristics thymic cortex of seven-month-old rats26 .67 %. The medulla to increased by 6.99 %., Intra-lobular perivascular space (VPP) by 1.66%. Interlobular septa increased by 7.98%. In the conditions of the middle mountains of Cholpon-Ata(1660 m above sea level), cell counts decreased, for example, the number of indicators of lymphoblasts decreased by 2.33%, average lymphocytes are 1.96%, small lymphocytes by 285.21%. Apoptosis bodies increased by 60.6%, mitoses by 2.13%, and Gassal bodies grew by 0.05% . Macrophage indicators increased by 0.14% . The stereometric characteristic of the cortical substance is 17.34%. The medulla is 6.62%. The intra-lobular perivascular space (VPP) is 1.32%. Interlobular septa is 5.68 per cent. The indicators of this study, newborn rats at high mountains conditions Naryn (2000 m above sea level) dynamics of cell populations in the conditional unit area of the cortical substance of the lobules of the thymus have a seven-month rats slightly decreased performance of the cells compared to the Midlands Cholpon-ATA Thus, the city of Bishkek in low-mountains conditions, i.e. 770 m above sea level, all indicators of the control group are within the normal range. In high-mountains conditions (3200 m above sea level), a noticeable change in cells, for example, the number of lymphoblast counts increased by 3.44%, medium lymphocytes increased by 2.03%, small lymphocytes by 316.8%. Apoptotic bodies 59.8%, mitoses 2.1%, Gassal corpuscles increased by 0.09%. Exponent macrophages increased by 0.12%. Stereometric characteristics thymic cortex of seven-month-old rats 26.67 %. Brain matter increased by 6.99 %., Intra-lobular perivascular space (ILP) by 1.66%. Interlobular septa increased by 7.98%. The data of Cholpon-Ata compared to Bishkek are slightly increased. Figures in mountainous Naryn (2000 m above sea level) dynamics of cell populations in the conditional unit area of the cortical substance of the lobules of the thymus have a seven-month rats revealed slightly decreased performance of the cells compared to medium Cholpon-Ata. _________________________________________________________________________________________________

Shynykul Zhanserik
Master of natural science, teacher, department of fundamental medicine, higher school of medicine, Kazakh National University named after Al-Farabi, Almaty city, Kazakhstan Email: shynykul.zhanserik@med-kaznu.com Spider venom contains a wide repertoire of pharmacologically active compounds, and in the case of some spider species bite, toxins from spider venom can play a fatal role for humans as well as other organisms. Among all the spiders, one could say the bite of Latrodectus tredecimguttatus, known as Black Widow spider, is very dangerous and can even lead to tragic consequences. Especially, voltage-gated sodium channels are responsible for propagating action potentials in excitable cells. NaV1.5 plays a crucial role in the human cardiac muscle, where it enhances the influx of sodium ions via the cell membrane, causing the fast depolarization phase of the cardiac action potential. It is also an important therapeutic target for heart disorders. Various venom-derived peptides have been observed as potential modulators of sodium channels, and these biologically active peptides are an abundant source for pharmacological tools. The aim of this study was to determine a novel peptide modulators of the human channel Nav1.5 in the venom of the Kazakhstan Black Widow spider (L. tredecimguttatus). The spiders (L. tredecimguttatus) were captured from the South and West regions of Kazakhstan. Venom was extracted to find novel neurotoxins and determine their activity on ion channels. Gel filtration chromatographic technique along with reverse-phase high-pressure liquid chromatography (R-P HPLC) was used for extensive purification. The next step was the functional screening of the purified components applying patch clamp electrophysiology. The functional screening revealed the presence of several ion channel modulators in Black Widow spider venom. Subsequently, MALDI-TOF and Edman degradation were applied to determine the molecular weight and peptide sequence. Determination of the peptide sequence allowed us to deduce toxin sequences and establish a sequence similarity with other similar toxins. A novel peptide modulator of the human channel NaV1.5 was isolated and identified as Ltre-2. The average molecular mass of the isolated toxin was 3.5 kDa. Further studies of Black widow spider toxins will help to better understand the structure-functional relationships, identification of binding sites on modulated ion channels and also explain the relationship between venom envenomation and symptoms. _________________________________________________________________________________________________  (1986). RESULTS OF THE STUDY: 28 (28.6%) of the examined patients showed an increase in the content of IRI in the blood serum, 5 (5.1%) had fasting glycemia, 6 (6.1%) had impaired glucose tolerance, the excess of the HOMA index was observed in 56 (57.1%), an increase in CS in 6 (6.1%), TG in 18 (18.4%). The combination of these changes includes children under the age of 10 years in the risk group for MS in 84.6 %, and in children 10 years and older; it is possible to diagnose MS in 56.9 % of cases (IDF, 2007). Аctivation of neuro-humoral mechanisms and violation of metabolic processes contributed to the development of arterial hypertension in 24 (24.5%) children, concentric LV remodeling in 18 (18.4%), concentric LV hypertrophy in 8 (8.2%) and eccentric LV hypertrophy in 7 (7.1%) children according to the results of ECHO-KG. CONCLUSIONS: Thus, obesity in children and adolescents is accompanied by pronounced changes in carbohydrate and lipid metabolism and LV myocardial remodeling mainly in the concentric type, which indicates a high risk of cardiovascular diseases (CVD) and requires early correction of metabolic disorders, development of preventive measures. _________________________________________________________________________________________________

Al-Farabi Kazakh National University, Almaty ( Kazakhstan)
Introduction. According to the World Health Organization, to date (December 2020) 1 519 193 Covid-19 deaths have been officially registered. Clinical manifestations can range from flu-like symptoms such as fever, dry cough, myalgia, and fatigue, often associated with hypo / anosmia and age [1,2], to more severe conditions with shortness of breath and respiratory distress requiring hospitalization in an intensive care unit. therapy and extended respiratory care [3,4]. The most common clinical manifestation of coronavirus infection is bilateral pneumonia, with 3-4% of patients developing acute respiratory distress syndrome (ARDS), but the exact mechanism of how Covid-19 leads to ARDS is unclear [5]. Goal. To study the structure of the causes of deaths with Covid-19 during a pandemic. Methods. A retrospective study was carried out on the basis of the therapeutic department of the city clinical hospital. An analysis was carried out on 76 case histories of deceased persons for the period from June to September 2020. In the course of studying the case histories, it was revealed that ARDS is in first place in the number of deaths (55.26%), of which 52.38% were men, the remaining 47.62% were women. The second is heart failure (HF) (19.74%). In third place is multiple organ failure (MOF) (15.79%). The last position in the list of causes of death is taken by pulmonary embolism (PE), with 9.21%, respectively.It should be noted that sepsis was absent among the causes of death, since all patients were required to use antibacterial drugs. The overwhelming majority of deceased persons belonged to the age category 50-54 and 55-59 years old, where the deaths from ARDS were 9.52 and 14.28; from CH 13.33 and 33.33; from PON 16.67 and 25% and from PE in both groups at 28.57%, respectively. This, in turn, confirms the need to study polymorbid conditions in this age category of persons. Conclusion. The results of our study show that the main causes of death in people with Covid-19 were ARDS, heart and multiple organ failure, mainly in the 50-60 year old category of people. The causes associated with heart disease were infarction, myocarditis, dilated cardiomyopathy, acute coronary syndrome due to hypoxemia. Thus, indicators such as

THE SECOND INTERNATIONAL SCIENTIFIC -PRACTICAL VIRTUAL CONFERENCE -MODERN MEDICINE: PROBLEMS, PROGNOSES AND SOLUTIONS
structure and the features of pneumatization of the sphenoidal sinus. The presellar type of sphenoidal sinus has a virtually low adherence to changes in sinus canals in types II and IV. Thus, careful planning of trans-sphenoid access to the sella is possible with modern imaging methods. Different anatomical variations can be detected so that problems can be predicted to be assessable. In order to avoid morbid consequences during surgery, it is imperative that clinicians determine the location and extent of sphenoid sinus walls and its relation to adjacent vital structures whenever trans-sphenoid pituitary surgery is expected. The few surgical tips related to sphenoid sinus anatomical configuration are important to keep in mind during such an approach. Keywords: MRI; sphenoid sinus; pneumatization; internal carotid artery; optic nerve. _________________________________________________________________________________________________

Beta-lactamase genes carried by multi-drug resistant enterobacteriaceae
Didbaridze T The First University Clinic of the Tbilisi State Medical University, Tbilisi, Georgia.
Background: The prevalence of the beta-lactam resistant enterobacteriaceae, specifically the 3 rd generation cephalosporins and carbapenems, is steadily increasing and spreading globally. Antibiotic resistance is supported by various molecular mechanisms, including intrinsic and acquired resistance genes.. Here, we examined an antibiotic resistance phenotype and beta-lactam gene content of MDR clinical isolates of enterobacteriaceae, recovered from patients atintensive care units of multi-profile hospitals in the Country of Georgia.