Outcomes of severe variants of acute infectious diarrhea in children with acute renal injury/failure (ARI/ARF) remain unsatisfactory, and mortality reaches 70% and more. ARI/ ARF therapy requires high material costs, which represent significant burden on health financing systems. It makes us consider AFR as one of the most important medical and social problems.The aim of our study was to investigate predisposing factors contributing to the development of renal dysfunction in acute infectious diarrhea associated with hemocolitis (AIDH), as well as to study the relationship of the developed renal dysfunction with the severity of endogenous intoxication, damage of vascular endothelium and hemostasis system.We examined 60 sick children with AIDH, divided into two groups: with ARF and without kidney pathology.Susceptibility to ARI/ARF in severe forms of AIDH is mediated by early childhood (up to 3 years in 89,5% of patients), artificial and mixed feeding (in 52,6% and 36,8% of children respectively), pathology of pregnancy in the first trimester, mother diseases during pregnancy (84,2%) and the late admission to hospital (89,5%) on the 4,9±0,2 day of the disease, i/m administration of furosemide without volume circulating blood restoration, i/m administration of nephrotoxic antibacterial medicines. Shigella spp. and Escherichia coli as etiologic factors of diarrhea in 42,1% and 47,4% of cases respectively. Thus due these parameters we can predict the loss of kidneys adaptation ability in diseases with severe course including acute infectious diarrheas.Interrelationships between elevation of the number of antigen binding lymphocytes to tissue antigens of vascular endothelium up to 8,1±0,6% in children with ARF and development of hemorrhagic syndrome (decrease of PTI to 72,5%) and intensity of endogenic intoxication (average molecular peptides up to 9,7±0,6 g/l) and worsening of AFR signs were established.Thus, it was found that AKI most often develops when rehydration therapy is started late or inferiorly performed, when nephrotoxic antibiotics and loop diuretics are prescribed without circulating blood volume (CBV) compensation and is accompanied by an increase in the degree of endogenous intoxication and vascular endothelial damage.

The global outbreak of the new coronavirus infection COVID-19 is still ongoing, leading to coinfections such as malaria and COVID-19 and others. As evidenced by the increase in various reports of coinfections. In recent years, Uzbekistan has achieved epidemiological stability for malaria and in 2018 received an official World Health Organization certificate confirming the country’s “malaria-free” status. At the present stage during the COVID-19 pandemic, imported malaria from abroad is relevant for our republic and, therefore, there is a constant danger of renewed transmission from imported cases. In this article presented the clinical case of coinfection of COVID-19 and malaria in a patient. From the epidemiological data, the patient was a citizen of Cameroon. During treatment of coronavirus infection, the patient noted intermittent chills all over the body and sweating, clinical symptoms of tropical malaria began to appear. Microscopy of a thick drop and a thin blood smear confirmed the presence of Pl. falciparum. The patient was prescribed antimalarial therapy with mefloquine, resulting in clinical recovery.

The aim of the study was to evaluate the effect of antiviral therapy prescribed at the outpatient stage on the course and outcomes of COVID-19 in hospitalized patients.Materials and methods. The retrospective study included 182 hospitalized patients with COVID-19 of moderate severity who received various initial therapy in the period before hospitalization. In the main group (91 patients), therapy included antiviral drugs: favipiravir or umifenovir, in the comparison group (also 91 patients), the treatment regimens did not contain etiotropic drugs against SARS-CoV-2.The groups were comparable in age, gender and severity of the disease. All patients received antipyretic drugs (paracetamol), vitamin therapy, according to indications -local antiseptics, mucolytics, antiplatelet agents and antibacterial drugs. The effectiveness of treatment was evaluated on days 7 and 14.Results. The presence of the virus was significantly less frequently detected on day 7 -in 15.38% and on day 14 of the disease -in 2.20% among patients receiving antiviral therapy, 82.42% and 39.56%, respectively in the comparison group. The average duration of the disease was more than 5 days less -8.28 ± 3.74 days. The proportion of patients with a deterioration in their clinical condition to 3-4 points was significantly higher in the group that did not receive antiviral drugs -61.54%, and with the use of favipiravir or umifenovir -2.2%.Conclusions:1. Timely administration of antiviral therapy for COVID-19 at the outpatient stage prevents the increase in severity, the development of complications, promotes earlier elimination of the virus and shortens the duration of the disease during hospitalization of the patient.2. The absence of antiviral therapy with moderate severity of COVID-19 at the outpatient stage significantly increases the risk of deterioration of the patient's condition.