Tremor are involuntary, rhythmic, oscillatory movements of a body part. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common types are enhanced physiological tremor, essential tremor, and parkinsonian tremor. The first step in evaluating a patient with a tremor is to classify the tremor based on its activation state, topographic distribution, and frequency. We analyzed the medical records of 99 patients who applied with complaints of tremor to the Regional Clinical Hospital, which showed that the most common diagnoses in patients with tremor were Parkinson's disease (44.4 %) and essential tremor (15.1 %).

The study presents an analysis of the literature devoted to the study of neurobiological processes of pathogenesis and therapy of tension headache. The characteristics of individual links of pathogenesis are given. Medicinal and non-medicinal methods of therapy of this pathological condition are considered.

Objective. This study aims to analyze the prevalence and developmental factors of neck pain among students of Russian higher education institutions, with an emphasis on the impact of this pain on quality of life, academic activities, and overall well-being of students.

Materials and Methods. The study is based on data obtained from 780 students through a survey conducted on the Google Forms platform. Descriptive statistics and correlational analysis methods were applied, utilizing SPSS software for data processing.

Results. A high prevalence of neck pain among students (75.4 %) was identified. The analysis revealed a connection between neck pain and various aspects of life, including physical activity, stress, the use of mobile devices, and levels of physical activity. A correlation between neck pain and the psychosocial health of students was also established, particularly with anxiety and depression.

Conclusions. The study underscores the necessity of a comprehensive approach in the prevention and treatment of neck pain among students. The development of programs aimed at improving the physical and psychological health of students is recommended, including exercises for neck and back, lifestyle modification, and psychological support.

Stroke remains the most common cause of death and permanent disability in the developed countries of the world. One of the main predictors of a good outcome is both mostly fast and safety recanalization of the occluded vessel of the brain. Over the past decade, endovascular therapy became a promising therapeutic approach for patients with acute ischemic stroke in combination with early usage of high-resolution methods of neuroimaging. This article discusses a clinical case of severe ischemic stroke due to occlusion of a major artery, confirmed by CT angiography. The efficacy of reperfusion therapy with intravenous administration of alteplase in combination with thrombectomy was demonstrated, the most common intra-arterial recanalization complications were pointed out. The early recognition of sudden complications with rapid decision-making for therapy modification during bridged reperfusion therapy is important for improving results of trearment.

Diabetic polyneuropathy (DPN) is one of the most common complications of diabetes mellitus, leading to the development of flaccid paresis, neuropathic pain syndrome, sensitive ataxia, as well as trophic disorders in the distal parts of the lower extremities.

The purpose of the randomized, open-label, comparative, prospective study was to evaluate the effectiveness and tolerability of ipidacrine in the complex treatment of patients with DPN.

Materials and methods. Patients with DPN (n = 60) were randomized into 2 groups. Both groups received basic therapy (alpha-lipoic acid, B vitamins, gabapentin); in the treatment of patients of the main group (n = 30), in addition, ipidacrine was used (Ipidacrine-SZ, North Star Co., Russia). We have analyzed the intensity of pain syndrome (VAS-P), the average daily dosage of gabapentin, and the results of the neuropathic dysfunctional scale (modified version, NDSm), Pittsburgh Sleep Quality Index, PSQI), Global Rating of Change Scale (GROC), the results of electroneuromyography (ENMG). The total duration of the observation and treatment period was 2 months.

Results. After 2 months of therapy in the main group of patients, compared with the control group, there was significantly more complete pain control (VAS-P: 3.0 ± 0.9 vs 3.6 ± 0.8), a decrease in the average daily dosage of gabapentin (390 vs 500 mg/day), reduction in the severity of clinical manifestations of polyneuropathic syndrome (NDSm: 4.4 ± 1.0 vs 4.9 ± 1.0 points) and improvement in sleep quality (PSQI: 6.8 ± 1.3 vs 7.9 ± 1.7). According to ENMG data, patients in the main group showed a significant improvement in the neurophysiological parameters of both motor and sensory fibers, which was significantly more pronounced compared to the control group. A significantly larger proportion of patients in the main group assessed the improvement from the therapy as ‘pronounced’ (GROC: 10/33.3 % vs 6/20.0 %).

Conclusions. The use of ipidacrine in complex therapy of patients with DPN can significantly reduce the clinical manifestations of disease and improve the neurophysiological parameters of the peripheral nerves of the lower extremities. Ipidacrine can be considered as a basic drug for the treatment of patients with neurological complications of diabetes mellitus.

The relevance of the joint use of rhythmic transcranial magnetic stimulation (rTMS) and speech therapy correction in children with autism spectrum disorder (ASD) and delayed psycho–speech development (PSRR) is associated with the high frequency of occurrence of these nosologies. The work highlights the experience of a therapeutic multidisciplinary approach in the correction of delayed psychomotor and psychorechological development in children with (ASD) and (ZPRR).The combined use of rTMS and speech therapy classes turned out to be more effective in the group of children with (ASD) in terms of reducing psycho-emotional reactions, which made it possible to achieve a greater effect in impressive speech.

The aim of the study was to assess the relationship of serum vitamin D concentration with impaired cardiometabolic profile in hypertension in patients with and without osteoarthritis of the knee joints.

Materials and methods. The results of the examination of 196 patients aged 54.06±9.4 years with arterial hypertension (AH) were analyzed, who were divided into groups depending on the presence of osteoarthritis of the knee joints (OA KS): 1st–patients with AH (n=153) and 2nd–patients with AH+OA KS (n=43).All patients were assessed for the level of 25 (OH) D, biochemical parameters of blood plasma (total cholesterol, low and high density lipoproteins, triglycerides, creatinine), cardiac morphometry using ECHOCG.

Results. The proportion of people with adequate vitamin D levels was 1.2 times higher among patients with AH+OA CS (32.6 % vs. 26.1 %, p0.05). Additional vitamin D supplementation was significantly more common in the group of patients with AH+OA (0 % vs. 44 %, p<0.001).The subgroup with vitamin D deficiency in patients with hypertension without OA CS had the most unfavorable «cardiometabolic» profile (they had significantly high BMI, total cholesterol, and LVH).

Conclusions. In people with arterial hypertension (without OA CS), violations of vitamin D levels (deficiency or insufficiency) are associated with an unfavorable «cardio-metabolic» profile – they need additional testing of vitamin D levels in the blood and correction of the detected violations. The presence of pathology of the musculoskeletal system (OA CS) in patients with arterial hypertension, it had no effect on the level of vitamin D and the frequency of its individual disorders. However, in this cohort of patients (AH+OA), the use of vitamin D supplements was significantly more common (0 % vs. 44 %, p<0.001). The assessment of the effect of vitamin D supplementation on cardiometabolic status deserves further investigation. Patients with arterial hypertension and its combination with comorbid pathology have, on average, vitamin D levels classified as insufficiency.

The goal of this study. The goal is to evaluate the effectiveness of using upper limb coordination training after reverse shoulder arthroplasty.

Material and methods. 30 patients were examined in Federal State Budgetary Institution «National Medical Research Center for Rehabilitation and Balneology» of the Ministry of Health of the Russian Federation. They were examined in a long-term period after reverse shoulder arthroplasty (in 3–4 months) and were divided into two groups: the main and the comparison groups. All patients were similar in terms of gender and age. Their clinical and functional parameters of the shoulder joint were also comparable. The patients in the comparison group were treated with laser therapy, electrotherapy, massage, group exercises to train the upper limb and mechanotherapy. The patients in the main group additionally underwent coordination training with biological feedback to the shoulder joint.

The results of the study were evaluated according to the pain syndrome, functional activity of the shoulder joint, shoulder joint flexion angle and values of dynamic strength of the shoulder muscles. After the course of medical rehabilitation, the patients in both groups showed improvement of all clinical and functional parameters of the shoulder joint. There was a statistically significant improvement in the dynamic strength of the shoulder joint and reduction of pain syndrome in the patients in the main group.

Conclusions. The inclusion of shoulder coordination training allows to improve the rehabilitation results for the patients who undergo reverse shoulder joint arthroplasty.

The article describes a clinical case of pituitary adenoma. It is known, that a pituitary adenoma is a benign tumor formation emanating from the glandular tissue of the anterior pituitary gland. Its growth is accompanied by endocrine, neurological and neuro-ophthalmological complications, which is a serious problem in modern neurosurgery due to the involvement of the most important anatomical structures in the pathological process and makes radical tumor resection difficult with a minimum number of complications.

The most common cause of spinning vertigo is benign paroxysmal positional vertigo (BPPV). Most cases are related to idiopathic BPPV, which pathogenesis is still not fully understood. In this manuscript the clinical case of recurrent benign paroxysmal positional vertigo is depicted. BPPV in this case was occurred primary in menopausal period. A clinical feature of this case is its combination not only with vitamin D deficiency and postmenopausal osteopenia (confirmed according to osteodensitometry), but also with secondary hyperparathyroidism, laboratory confirmed. The literature has accumulated data to link the development and recurrence of BPPV with vitamin D deficiency and osteoporosis, but few comprehensive studies of all crucial indicators of calcium-phosphorus metabolism in these patients have been published. Meanwhile, according to the author, a comprehensive endocrinological study of calcium-phosphorus metabolism in a patient with newly diagnosed BPPV can help optimize therapy for this category of patients.

The article presents the results of a comprehensive scientific comparative analysis of the results of the study of statistical and epidemiological indicators of autism incidence in the population of the Kabardino-Balkar Republic for 2019–2021, which is of practical importance in describing the diverse manifestations of autism incidence dynamics on the territory of a separate region of the Russian Federation. The results of the study of the probable relationship of age, sex, place of residence and social everyday features with the prevalence of autism in the population of the Kabardino-Balkar Republic showed that autism is more prevalent among the child population of the Kabardino-Balkar Republic. The leading position among the identified cases of autism is in male children under 14 years of age living in urban settings. Any peculiarities in the change of living conditions were not revealed. This suggests a connection between autism and demographic indicators, with no connection with social features of residence in the region.