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Gafarov T.A.
NARCISSISM AMONG PHYSICIANS: CAUSES, CONSEQUENCES, AND MANAGEMENT
Abstract: The article discusses the development, professional manifestations, and potential consequences of narcissistic traits among physicians. Available evidence indicates that narcissism should not be regarded exclusively as a negative characteristic. Moderate self-confidence, decisiveness, initiative, and leadership tendencies may have an adaptive role in certain clinical and organizational settings. However, grandiosity, a sense of superiority, intolerance of criticism, an excessive need for admiration, reduced empathy, and disregard for the opinions of others may adversely affect teamwork, physician–patient relationships, and professional behavior. The expression of narcissistic traits may be influenced by the professional environment, high levels of responsibility, competition, hierarchical training systems, and opportunities for self-presentation through social media. The presence of individual narcissistic traits does not in itself constitute a diagnosis of narcissistic personality disorder. The aim in medical settings should therefore not be to restrict healthy professional self-confidence but to prevent maladaptive behavior. Ethical conduct, empathy, constructive feedback, teamwork, psychological safety, and accountable professional practice are important measures for reducing its potentially adverse consequences.
Keywords: narcissism, physicians, personality traits, professional behavior, patient safety, management
Mammadova R.R., Isayev I.I., Hajiyeva M.R., Mustafayeva A.I.
A MODERN APPROACH TO ORGANIZING A SCREENING PROGRAM
Abstract: Disease screening is one of the most important tools of modern public health and preventive medicine. Screening programs have a long and distinguished history in controlling epidemics of infectious diseases and developing treatments for chronic diseases. As these screening programs have been implemented over the years, significant experience has been gained. If screening programs are poorly conceived, organized, or implemented, they can lead to questionable interventions and put groups and individuals at risk. In this article, we have tried to shed light in detail on the organization of screening programs, the characteristics of the examinations, and what to pay attention to when implementing screening programs.
Keywords: disease screening, screening programs, screening tests, universal screening, selective screening
Bandalizade G.S., Janahmadova Sh.N., Bakhshiyeva S.G.
HOOKWORM INFECTIONS IN THE REPUBLIC OF AZERBAIJAN: BEFORE AND AFTER PRACTICAL ELIMINATION AND A FORECASTS FOR THE NEAR FUTURE
Abstract: The aim. To assess the dynamics of the spread of hookworm infections in the Republic of Azerbaijan before and after the implementation of comprehensive elimination measures, identify current risk factors, and evaluate the prospects of the epidemiological situation based on historical and contemporary data. Material and Methods. Population surveys conducted in 1956–1960 demonstrated a high prevalence of hookworm infections, reaching 59.7±0.8% in the Lankaran district and 56.8±0.9% in the Zagatala district. In most cases, the intensity of infection was low to moderate; however, foci with high parasitic burden were also identified, indicating heterogeneity of the epidemiological process. Following comprehensive anti-hookworm control measures implemented during 1960–1986, including mass deworming campaigns, sanitary education, and improvement of sanitary conditions, the infection rate among the population significantly decreased, and the disease was practically eliminated in five of the eight endemic districts, confirming the effectiveness of the implemented measures. R Despite the achieved success, residual foci have persisted over the last 30–35 years, while no large-scale population surveys have been conducted. Modern social and environmental changes, including increased population migration, expansion of agricultural activities, and development of tourism in endemic regions, increase the risk of renewed transmission of the infection. The annual registration of 6 to 148 hookworm cases during 1990–2025 confirms the persistence of residual foci and highlights the need for continuous epidemiological surveillance and monitoring. Conclusion. Further studies are needed to clarify the current epidemiological situation of hookworm infections, comprehensively assess risk factors, and develop targeted preventive measures aimed at preventing renewed transmission of the infection. This is essential to ensure sustainable sanitary and epidemiological well-being of the population and to prevent the possible re-establishment of the disease in endemic regions.
Keywords: hookworm infection, endemic areas, subtropical climate, epidemiology, residual foci, prevention, deworming
Mammadov E.Kh., Mammadov N.I.
PREVENTION AND TREATMENT OF PARASTOMAL COMPLICATIONS: RESULTS OF A RETROSPECTIVE STUDY
Abstract: Objective. To evaluate the incidence, risk factors, prevention, and treatment outcomes of parastomal complications. Material and methods. A retrospective analysis of 425 patients who underwent ileostomy or colostomy formation between 2008 and 2025 was performed. Early and late parastomal complications, their causes, preventive measures, and treatment strategies were assessed. Statistical comparisons were carried out between the study and control groups. Results. The most common early complications were peristomal skin lesions, separation between the stoma and surrounding skin, and infectious inflammatory complications. The proposed surgical technique significantly reduced the incidence of stoma retraction, prolapse, parastomal abscess, and parastomal hernia. The greatest benefit was observed in patients with a body mass index greater than 30 kg/m². Conclusion. Proper stoma construction, adequate drainage of the parastomal area, appropriate postoperative stoma care, and long-term follow-up play a key role in preventing parastomal complications. The proposed technique effectively reduces both early and late complications and may be recommended for routine clinical practice.
Keywords: colostomy, ileostomy, parastomal complications, prevention, treatment, retraction, prolapse
Bağırova L.H.
LEVEL, RISK FACTORS, AND REGIONAL CHARACTERISTICS OF MORTALITY FROM CHRONIC KIDNEY DISEASE ASSOCIATED WITH KIDNEY PATHOLOGIES
Abstract: Objective. To assess the mortality rate from chronic kidney disease associated with kidney pathologies in the population of Azerbaijan depending on age, gender, education level, and permanent place of residence. Material and methods. All death cases in Azerbaijan in 2023 (398 cases) caused by chronic kidney disease associated with kidney pathologies were analyzed. The frequency of death cases was determined by gender, education level, age, and place of residence. Results. In Azerbaijan, there were 3.9±0.19 deaths per 100,000 population. The risk of death varied depending on gender, age, education level, and place of residence. Conclusions. The gender difference in mortality rates from chronic kidney disease associated with kidney pathologies was not significant (4.3±0.260⁄0000 among men and 3.6±0.260⁄0000 among women). Mortality rates were significantly higher among people with secondary and primary education (6.9±0.370⁄0000). With age, the frequency of deaths from chronic kidney disease associated with kidney pathologies increased dynamically (from 0.1 to 32.80⁄0000). There was a marked inequality in mortality risk across regions, cities, and districts under republican subordination.
Keywords: chronic kidney disease, kidney pathologies, risk factor, mortality, regional characteristic
Abstract: Objective. To assess the frequency and nosological causes of initial visits by women of reproductive age to obstetricians and gynecologists, using the Guba–Khachmaz economic region as an example. Materials and methods. The study was based on a database of initial visits to obstetricians and gynecologists in the Guba–Khachmaz economic region in 2024. The visits were classified into four age groups (15–19, 20–29, 30–39, and 40–49 years) and according to the patients’ district of residence. The reasons for consultation were grouped according to the three-character ICD-10 categories and their corresponding disease classes. Statistical analysis of the collected data was performed using methods appropriate for qualitative variables. The total number of visits per 1,000 women of reproductive age, as well as the frequency of causes of consultation according to individual three-character ICD-10 categories, was calculated. Results. The frequency of initial visits among women of reproductive age was relatively high in Guba district and relatively low in Siyazan district. Comparison of the administrative districts according to this indicator demonstrated statistically significant differences between Guba and all other districts (P<0.05), whereas the comparison between Shabran and Siyazan did not reveal a statistically significant difference. The age-related pattern of initial visits was similar and statistically significant. The rate was low among women aged 15–19 years, which may be attributed to the lower demand for reproductive health services in this age group. In the subsequent age groups, the frequency of visits increased markedly in parallel with the increasing need for such services. Conclusion. The frequency of visits to obstetricians and gynecologists among women of reproductive age in the Guba–Khachmaz region ranges from 346.8±5.2 to 391.8±2.7‰ and differs significantly between the administrative districts of the region, being relatively higher in Guba and lower in Siyazan. The frequency of initial visits to obstetricians and gynecologists increases with age, and the accuracy of the regression model describing this trend approaches 100% (R²=1.0). The most common reasons for initial visits include conditions related to pregnancy, childbirth and the puerperium (O00–O99), supervision and monitoring of normal pregnancy, and non-inflammatory and inflammatory diseases of the female genital tract. Among visits related to pregnancy, childbirth and the puerperium, the largest proportion is attributable to complications of the puerperium, maternal disorders predominantly related to pregnancy, issues related to delivery, conditions affecting the fetus and the amniotic cavity, and complications encountered during delivery.
Keywords: reproductive age, visits to an obstetrician-gynecologist, region
Nasirova F.J., Dadashova L.F., Quliyeva A.O.
EMPIRICAL ANALYSIS OF FEATURES OF METASTASIS OF MALIGNANT TUMORS
Abstract: Metastasis is a factor determining the progression and prognosis of malignant tumors. The nature of tumor spread depends on the tumor biology, age and gender of the patient. Objective. To assess the frequency, pathways and locations of metastases of the most common malignant tumors. Material and Methods. A retrospective analysis of data from 337 women, 201 men and 38 children with cancer was conducted. Bone metastases were assessed using bone scintigraphy. Results. Among women, breast cancer exhibited the highest metastatic activity, with a predominant spread to the spine and pelvic bones. This pattern is linked to vertebral venous plexus involvement and a prolonged asymptomatic course. Uterine cancer rarely resulted in distant bone metastases due to local tumor growth and early clinical detection. Lung cancer showed intermediate bone involvement. In men, prostate cancer had the greatest tendency to metastasize to bone, this is due to the fact that prostate cancer cells have an affinity for bone, especially the spine and pelvis. Lung cancer displayed moderate bone metastatic activity, mainly involving the spine and ribs, corresponding to hematogenous dissemination. Gastrointestinal tumors commonly metastasized to the liver and lungs, with skeletal involvement occurring rarely and usually at advanced stages. In children, embryonal tumors, sarcomas, and lymphomas predominated, characterized by high proliferative activity and early systemic spread. Neuroblastomas frequently involved bones and bone marrow, while lymphomas were systemic at presentation. Sarcomas, including osteosarcoma, Ewing sarcoma and rhabdomyosarcoma, demonstrated aggressive behavior with early hematogenous and lymphogenous dissemination. Conclusion. Age, gender of the patient and biological characteristics of tumors are key to early diagnosis, accurate staging and selection of optimal treatment strategies. Considering these factors into account improves prognosis, survival and quality of life for patients.
Keywords: diagnosis of metastases, malignant tumors, age, gender
Shikhaliyev Y.Şh., Kazimova L.H., Ismayilova A.S., Aliyev C.G., Abbasova A.S.
THE ROLE OF QUANTITATIVE AND QUALITATIVE INDICATORS IN THE ANALYSIS OF THE EPIDEMIOLOGICAL SITUATION OF TUBERCULOSIS
Abstract: Metastasis is a factor determining the progression and prognosis of malignant tumors. The nature of tumor spread depends on the tumor biology, age and gender of the patient. Objective. To assess the frequency, pathways and locations of metastases of the most common malignant tumors. Material and Methods. A retrospective analysis of data from 337 women, 201 men and 38 children with cancer was conducted. Bone metastases were assessed using bone scintigraphy. Results. Among women, breast cancer exhibited the highest metastatic activity, with a predominant spread to the spine and pelvic bones. This pattern is linked to vertebral venous plexus involvement and a prolonged asymptomatic course. Uterine cancer rarely resulted in distant bone metastases due to local tumor growth and early clinical detection. Lung cancer showed intermediate bone involvement. In men, prostate cancer had the greatest tendency to metastasize to bone, this is due to the fact that prostate cancer cells have an affinity for bone, especially the spine and pelvis. Lung cancer displayed moderate bone metastatic activity, mainly involving the spine and ribs, corresponding to hematogenous dissemination. Gastrointestinal tumors commonly metastasized to the liver and lungs, with skeletal involvement occurring rarely and usually at advanced stages. In children, embryonal tumors, sarcomas, and lymphomas predominated, characterized by high proliferative activity and early systemic spread. Neuroblastomas frequently involved bones and bone marrow, while lymphomas were systemic at presentation. Sarcomas, including osteosarcoma, Ewing sarcoma and rhabdomyosarcoma, demonstrated aggressive behavior with early hematogenous and lymphogenous dissemination. Conclusion. Age, gender of the patient and biological characteristics of tumors are key to early diagnosis, accurate staging and selection of optimal treatment strategies. Considering these factors into account improves prognosis, survival and quality of life for patients.
Keywords: diagnosis of metastases, malignant tumors, age, gender
Aliyarbayova A.A., Hasanov I.A., Unal G., Cinar-Asa S.
MACROPHAGE MIGRATION INHIBITORY FACTOR EXPRESSION IN LUNG DISEASES: AN EXPLORATORY GENE EXPRESSION PROFILING STUDY
Abstract: Macrophage Migration Inhibitory Factor (MIF) is a key inflammatory cytokine implicated in immune regulation and tumour biology. Its role in lung disease, particularly in relation to tumour differentiation and clinical risk, remains incompletely understood. This study aimed to evaluate the expression pattern of MIF in lung disease using gene expression profiling, assess its variation across histological grades, and determine its association with clinical risk. A secondary data-based exploratory analysis was conducted using microarray gene expression data from 442 lung tissue samples obtained from a publicly available dataset. MIF expression was extracted using probe ID 200799_at from the Affymetrix Human Genome U133A platform. Samples stratified based on histological differentiation into well, moderate, and poorly differentiated groups. Statistical analyses included descriptive statistics, Welch’s t-test, Pearson correlation, and linear regression. MIF expression demonstrated a significant increase with decreasing tumour differentiation, with the highest levels observed in poorly differentiated tumours (11.05±0.68). Independent t-tests confirmed significant differences between all histological groups (p<0.05). However, correlation analysis revealed a weak and non-significant association with clinical risk (r=0.06, p=0.20) and regression analysis indicated minimal predictive power (R²=0.003). MIF expression is significantly associated with tumour differentiation in lung disease but lacks predictive value for clinical risk. These findings suggest that MIF serves as a marker of tumour biology rather than a standalone prognostic biomarker.
Keywords: macrophage migration inhibitory factor, lung cancer, gene expression, tumour differentiation
Hasanov M.J., Agakishiyev A.N., Garayev G.Sh.
THE IMPACT OF CONCOMITANT DISEASES ON THE OUTCOMES OF SURGICAL TREATMENT OF CHOLECYSTITIS
Abstract: Gallstone disease (GSD) is one of the most common disorders of the hepatobiliary system. Its exacerbations, comorbidities, and complications may influence the choice of surgical strategy and treatment outcomes. Cardiovascular disease, diabetes mellitus, and obesity are particularly important because they are associated with increased perioperative risk. Objective. To retrospectively assess the pattern of concomitant diseases, complications of GSD, and treatment outcomes associated with different surgical approaches. Material and methods. Medical records of 2,016 patients examined and surgically treated for GSD at various private medical institutions between 2015 and 2025 were analyzed. Anamnestic factors associated with pain exacerbation, concomitant diseases, complications, surgical strategy, postoperative complications, and mortality were evaluated. Categorical variables were presented as absolute numbers and percentages. No inferential statistical tests were performed. Results. Acute right upper quadrant pain was the principal complaint in all patients. Pain exacerbation was associated with emotional stress in 40.0% of cases, consumption of fatty and excessive food in 25.5%, and combined intake of fatty food and alcohol in 21.0%. A sedentary lifestyle was reported in 60.0% of patients, while 23.0% were overweight. Concomitant diseases were recorded in 765 patients (38.0%): diabetes mellitus or hyperglycemia in 13.0%, arterial hypertension in 10.4%, obesity in 8.5%, ischemic heart disease in 5.0%, and bronchial asthma in 1.3%. Mortality among urgently operated patients with ischemic heart disease was 3.2%, whereas no deaths were reported in the planned-treatment group. Among patients with diabetes mellitus, mortality was 15.0% after two-stage intervention and 3.0% and 6.0% after one-stage emergency and planned surgery, respectively. Obstructive jaundice was observed in 32.0% of cases, and exacerbation of chronic pancreatitis in 8.0%. Conclusion. Concomitant cardiometabolic disorders and complications of GSD require individualized treatment planning. These descriptive findings highlight the importance of preoperative stabilization of comorbid conditions and multidisciplinary perioperative management.
Keywords: gallstone disease, cholecystitis, comorbidities, cholecystectomy, surgical outcomes
Orujova S.R.
THE ROLE OF MILITARY MEDICAL TRAINING IN IMPROVING MILITARY PERSONNEL’S AWARENESS OF OCULAR INJURIES
Abstract: The aim. The study was conducted to assess the level of awareness of ocular injuries, first-aid skills, and differences in knowledge related to refractive surgery and postoperative care among representatives of various military contingents. Material and methods. A total of 450 respondents were included in the study, of whom 205 had received military medical training, while 245 had not undergone training in this field. The mean age of the participants was 25.9 and 25.0 years, respectively. Statistical analysis was performed using SPSS software. Quantitative variables were evaluated using Student’s t-test, while categorical variables were assessed using Pearson’s χ² test. A p-value <0.05 was considered statistically significant. Results. The analysis demonstrated that individuals with military medical training provided significantly more correct responses across all sections relating to penetrating, contusion-related, thermal, chemical, and photochemical ocular injuries (p<0.001). By contrast, the proportion of incorrect and potentially harmful responses was markedly higher among participants without military medical training. While 71.2% of respondents with military medical training had obtained this information through formal education and specialized courses, the remaining participants predominantly relied on general information sources. Conclusion. Improving educational programmes, introducing simulation-based training, and expanding awareness-raising activities may help reduce the risk of ocular injuries among military personnel and enhance their combat readiness and medical safety.
Keywords: ocular injuries, military personnel, military medical training, first aid, level of awareness, refractive surgery
Aliyeva A.M., Polukhova A.A., Mammadova N.M.
THE ROLE OF TLR4 AND SIGIRR GENE PROFILE ALTERATIONS IN THE PATHOGENESIS OF NECROTIZING ENTEROCOLITIS IN PRETERM INFANTS
Abstract: Objective. To evaluate changes in Toll-like receptor 4 (TLR4) expression and the methylation profile of the SIGIRR gene in preterm newborns with necrotizing enterocolitis (NEC), to examine their associations with gestational age and birth weight, and to assess their possible significance in NEC pathogenesis. Material and methods. The study was conducted at the Scientific Research Institute of Pediatrics named after K.Y. Farajova. Laboratory analyses were performed at the Human Genetics Laboratory and at the DIAGEN and INTERGEN laboratories in Ankara. TLR4 gene expression was assessed in 50 blood samples by real-time polymerase chain reaction. The methylation profile of the SIGIRR gene was analyzed in 52 blood samples across 36 gene loci. Participants were stratified by birth weight into groups below and above 1500 g, and children with NEC were compared with corresponding comparison groups. Between-group differences were assessed using the Mann–Whitney U test, and associations between variables were evaluated by Spearman rank correlation. A p value <0.05 was considered statistically significant. Results. TLR4 ΔΔCt correlated negatively with gestational age (ρ=-0.419; p=0.006) and birth weight (ρ=-0.424; p=0.006). In children weighing less than 1500 g, differences in methylation at the SIGIRR %C90, %C100, %C102, and %C258 loci were found compared with the comparison group. In children weighing more than 1500 g, changes at %C327 and %C123 were recorded. Several statistically significant correlations were also found between SIGIRR methylation indices and TLR4 parameters. Conclusion. NEC in preterm newborns is accompanied by changes in TLR4 expression and the methylation profile of the SIGIRR gene. Gestational age and birth weight were associated with TLR4 parameters. Associations between methylation changes at SIGIRR loci and TLR4 parameters suggest a possible interaction between these signaling mechanisms in NEC pathogenesis. Larger studies are needed to determine the early diagnostic and prognostic value of these markers.
Keywords: necrotizing enterocolitis, preterm newborn, TLR4, SIGIRR, gene expression
Sharifova N.T., Hajiyeva N.N., Tagiyeva A.N.
GENETIC TESTING OF SURFACTANT-RELATED GENES IN TERM NEONATES WITH SEVERE RESPIRATORY DISTRESS: A DIAGNOSTIC APPROACH FOR CLINICIANS
Abstract: Although respiratory distress syndrome (RDS) is predominantly associated with functional immaturity of the surfactant system in preterm neonates, mutations in genes regulating surfactant metabolism may play an important role in the pathogenesis of severe and treatment-resistant RDS in term infants. This literature review aims to summarize the characteristics of surfactant-related gene mutations associated with RDS in term neonates and to evaluate their diagnostic significance. Available evidence indicates that pathogenic variants in SFTPB, SFTPC, ABCA3, and NKX2-1 may impair surfactant synthesis, intracellular processing, transport, and function, resulting in severe neonatal respiratory failure and interstitial lung disease later in life. SFTPD variants are better regarded as potential modifiers of RDS susceptibility and severity rather than established causes of monogenic surfactant dysfunction. Early genetic panel testing can facilitate a definitive diagnosis, improve prognostic assessment, guide individualized treatment decisions, and support appropriate genetic counselling for affected families. In the future, gene replacement, messenger RNA–based therapy, and protein replacement approaches may provide new opportunities for the targeted treatment of inherited surfactant disorders.
Keywords: respiratory distress syndrome, pulmonary surfactant, term neonates, surfactant dysfunction, SFTPB, ABCA3, genetic testing
Gasimova F.N., Mehdiyev S.X., Babayeva G.H.
ADVERSE EFFECTS OF GLUCOCORTICOID THERAPY: CURRENT EVIDENCE AND CLINICAL OBSERVATIONS
Abstract: This review presents current evidence on the most clinically significant complications of long-term glucocorticoid (GC) therapy, including metabolic disorders, glucocorticoid-induced diabetes mellitus, arterial hypertension, cardiovascular complications, glucocorticoid-induced osteoporosis, skin lesions, and secondary adrenal insufficiency. Particular attention is paid to current international recommendations on the rational use of glucocorticoids based on the principles of glucocorticoid stewardship, which advocate the use of the lowest effective dose for the shortest possible duration, regular safety monitoring, and timely prevention of treatment-related complications. The presented clinical cases illustrate severe cutaneous manifestations of chronic glucocorticoid toxicity and emphasize the importance of early recognition of adverse effects, individualized treatment strategies, and a multidisciplinary approach to patient management.
Keywords: glucocorticoids; adverse effects; glucocorticoid therapy; drug safety; glucocorticoid stewardship
Aslanova V.A., Gurbanova N.F., Nazarli J.A.
OCULAR MANIFESTATION IN IgG4-RELATED SYSTEMIC DISEASE
Abstract: The aim. To present a clinical case of lacrimal and thyroid gland involvement in the context of IgG4-related systemic disease. Material and Methods. A 56-year-old female patient underwent a standard ophthalmological examination, Schirmer and Norn tests, laboratory investigations, and orbital and abdominal magnetic-resonance imaging studies. Results. The patient was found to have bilateral dacryoadenitis, dry eye syndrome, eyelid edema, and a significantly elevated serum IgG4 level. A rheumatologist diagnosed IgG4-related systemic disease, and clinical improvement was observed under immunosuppressive therapy. Conclusion. In patients with long-standing dacryoadenitis and systemic manifestations, IgG4-related disease should be considered in the differential diagnosis, and a multidisciplinary approach should be applied.
Keywords: IgG4-related disease, dacryoadenitis, lacrimal gland, orbit, dry eye syndrome
