The aim of the study was to determine the comparative pedagogical effectiveness of the traditional lecture–seminar approach and the case-based learning (CBL) approach in teaching the discipline Internal Medicine. At the Department of Internal Diseases №1 of Avicenna Tajik State Medical University, a pedagogical experiment was conducted during the 2024–2025 academic year involving 128 fourth-year medical students. Four groups were trained using the CBL methodology,and four groups followed the traditional teaching method. Classes were organized in cycles of 4–6 academic hours per day. Both categories of students at tended eleven lectures; the difference concerned the format of practical sessions. Learning effectiveness was assessed based on cognitive, clinical, and motivational parameters. The evaluation methods included testing, expert assessment of clinical reasoning, questionnaires, andstatisticalanalysis (Student’s t-test, χ² test, Pearson’s correlation, odds ratio with 95%confidence interval). The results demonstrated that the CBL approach significantly improved knowledge levels(86.4±6.8 vs. 78.1 ± 7.3; p < 0.01), enhanced clinical reasoning (8.7 ± 0.9 vs. 7.2 ± 1.1; χ² =13.41; OR=3.86;p < 0.001), and increased learning motivation (81.3% vs. 62.5%; OR = 2.64; p <0.01). Studentswhoparticipated in case discussions demonstrated greater confidence in professional skills andmoredurable retention of material during subsequent assessments. The findings are consistent with international research data and confirmthat case-basedlearningenhances the efficiency of the educational process, promotes the development of analytical andclinicalreasoning skills, and aligns with modern requirements for medical training. The implementationofcase-based learning in teaching internal medicine is recommended as a strategic directionforimproving medical education. Keywords: medical education, internal medicine, case-based learning, clinical reasoning,pedagogical effectiveness, active learning

The purpose of the study. Features of the psychophysiological state of the female students' bodyagainst the background of marriages with close relatives in the conditions of study at the ATSMU. Materials and methods of research. The material for the study of the articlecontainsthecharacteristics of the psychophysiological parameters of the body of girls born onthebasisofconsanguineous marriages from dif erent regions of the Republic of Tajikistan and enrolledintheSEF"Avicenna TSMU". The results of the study. The results obtained on the psychophysiological characteristicsofgirlsborn in the context of close marriages can serve as the main factor due to the conditions of maintainingthe health of female students. Serious disorders of psychoemotional development (impulsivity, nervousdisorder, irritability, aggressiveness, etc.)), delayed physical development, chromosomal mutations(Down,Patau, Edwards syndromes, etc.), gene diseases (cystic fibrosis, gout, Marfa syndrome, Gaucher'sdisease,albinism, etc.), metabolic disorders, the most pronounced pathological processes characterizedbytheconsequences of incest. Conclusion. The risk of having sick children in a marriage with close relatives is 25%. Inthecaseof marriage with the son of an aunt, uncle, or uncle, the risk increases to 46%. It is due totheincreaseinthe number of incest in our country that the number of children born with physiological andmentaldisabilities is increasing every year. Over the past five years, out of 4,000 patients whoappliedtothegenetic department of the Research Institute of Obstetrics, Gynecology and Perenatology of theRepublicofTajikistan, 1,000 were caused by incest. This is not idle chatter, but clear evidence, that is, theresultofresearch. The analysis of the characteristics of psychophysiological indicators in descendants bornasaresult of closely related marriages indicates the presence of a number of negative trends. It hasbeenestablished that inbreeding increases the risk of genetic abnormalities, which can manifest itself intheform of cognitive disorders, emotional and volitional instability, as well as reduced adaptabilitytostressand sensory stress. Cases of delayed psychomotor development and weakening of neurophysiologicalreactions were also noted. The findings emphasize the need to prevent closely relatedmarriagesandstrengthen medical and genetic counseling in order to preserve the psychophysiological healthof futuregenerations. Key words: close marriage, psychophysiological features, type of temperament, adaptability,health, personality traits

Aim. To conduct a hygienic assessment of the functional state of the thermoregulatorysystemin workers involved in residential construction in Dushanbe. Materials and methods. The study involved 70 construction workers at a residential complexinDushanbe. Thermoregulation and fluid loss were assessed over 140 working days usingphysiologicalmethods. Body temperature was measured with a mercury thermometer, and skin temperaturewasrecorded using a TPEM-1 electrothermometer at four body sites. A total of over 280 skintemperaturemeasurements and more than 70 body temperature measurements were performed. The thermal stateof the body was evaluated according to SanPiN 2.2.4.548-96, with calculations of meanweightedskintemperature and mean body temperature. Fluid loss was determined by the difference inbodyweight,accounting for consumed fluids and excreted urine. Results. Temperature monitoring during work revealed the diurnal dynamics of thermalresponses. Measurements taken before, during, and after shifts identified seasonal differences:insummer, body temperature increased to 37.5°C and skin temperature to 35.2°C, whileinwinter,fluctuations were less pronounced (up to 33.4°C). A reduced temperature gradient betweenthechestand extremities indicated overheating and thermoregulatory strain. Fluid losses insummerreached5900 ml per shift, confirming significant dehydration. Subjective assessments of thermal discomfort(6–7 points) aligned with objective data, highlighting the issue’s relevance. Conclusions. In summer, construction workers exhibited elevated body temperature(upto37.5°C) and skin temperature (up to 35.2°C), a reduced temperature gradient, and significant fluidloss(up to 5900 ml per shift), indicating overheating and thermoregulatory strain. Inwinter, skintemperatures were lower, with less pronounced fluctuations. Subjective discomfort assessmentscorroborated physiological findings. The results underscore the need for preventivemeasures,including optimization of work schedules, hydration, and sanitary oversight. Keywords. Thermoregulation, temperature gradient, fluid loss, seasonal fluctuations,physiological strain, working conditions

Research objective. To study the features of clinical and anamnesis data in women who have undergone abdominal delivery. Research material and methods. A prospective analysis was conducted on 134 women. Among them, 100 women made up the main group, having a history of cesarean section, while the comparison group consisted of 34 women who were delivered naturally. Clinical and laboratory research methods were performed. Research results. Almost every third operated woman complained about symptoms of menstrual cycle disturbances. In the group of tumors and background diseases of the pelvic organs, uterine fibroids (25%) were the leading issue among women 31% of patients complained of pain in the lower abdomen, 29% reported leukorrhea. The frequency of ectopic pregnancy was significantly high (8.0%), as was the frequency of adhesive disease, which constituted 27,0% (P<0.001). Among inflammatory diseases of the cervix, the incidence of endocervicitis in the studied group was 32,5%, and endocervicosis was also noted in 32.5% of women, while in the comparison group, this figure was 20,5%. Cervical hypertrophy was noted in 3.7%, and polyps of the cervical canal were present in 1,25%, which were not found in women from the comparison group. Conclusion. Thus, the conducted studies on the examination of clinical-anamnestic data in women who underwent cesarean section showed a high frequency of pathologies of the genital organs in this group, which manifested as inflammatory processes, especially of the uterus, pathology of the cervix in the form of endocervicitis and endocervicosis, menstrual function disorders such as hyperpolymenorrhea and dysfunctional uterine bleeding, as well as uterine fibroids. Keywords: Cesarean section, cervical disease, colposcopy, clinical-anamnestic data.

Purpose of the study. To study the effectiveness of treatment of patients with severe radicular pain at the lumbar level of the spine unsuccessful to conservative treatment. Materials and Methods. The study included 30 patients diagnosed with herniated intervertebral discs of the lumbar spine with severe radicular pain syndrome over the last 2 years. At the time of the study, 100% of the patients were on medication but with temporary improvement. All study patients underwent transthoraminal, facet epidural blockade under electron-optic transducer monitoring. Results and discussion. In 21 (70 %) of the investigated patients the persistent positive effect of the performed blockades was maintained. Four (13.3 %) patients were operated, and five more (16.7 %) refused surgical treatment and continued conservative treatment with positive effect in dynamics. Thus, all patients had a significant decrease in the intensity of radicular and local low back pain. Conclusion. The use of lumbar spine blockades in the treatment of patients with radiculopathy discussed by herniated intervertebral discs of the lumbar spine is highly effective. Keywords: trigeminal neuralgia, neurovascular conflict, microvascular decompression.