The author of the presented review article introduces the reader to the basics of such an important clinical problem as acidosis. Respiratory (respiratory) and metabolic acidosis are isolated, which, in turn, is divided into metabolic, exogenous and excretory. Depending on the qualitative composition of the accumulated metabolic products, lactate acidosis and ketoacidosis are isolated. Dehydration and hypovolemia in lactate acidosis and ketoacidosis contribute to a decrease in the glomerular filtration rate and aggravation of acidosis by reducing the excretory function of the kidneys. The prognosis for patients with lactate acidosis is serious. According to Perez et al. (1965), Weil, Afifi (970), the mortality rate of patients with a lactate level of more than 4.4 mmol/l ranges from 18 to 73%, depending on the underlying disease.
The author introduces the reader in detail to the principles of correction of lactate acidosis and the mechanisms of compensation for metabolic acidosis. Physiological mechanisms of compensation for metabolic acidosis are implemented primarily by the lungs and kidneys. The article considers the types of excretory acidosis in kidney pathology and types of tubular acidosis, analyzes the causes of distal and proximal tubular acidosis

A large number of acidic foods is formed in the human body during the metabolism during the day. The main products of metabolism in the cell are acids that dissociate with the release of [H+] ions, but due to buffer systems, acidification of the intracellular medium does not occur. As a result of oxidative processes, volatile carbonic acid and non-volatile acids are formed in tissues, such as sulfuric acid (during the cleavage of methionine and cystine), uric acid (during the cleavage of nucleoproteins), free fatty acids of various molecular weights, as well as inorganic phosphates. During the day, up to 2-3 liters of hydrochloric acid are formed in the gastric mucosa.
Maintaining the constancy of the pH of the blood, interstitial and cellular sectors is ensured by buffer systems that maintain the pH at the optimal level for the function of organs and tissues

The aim of this work was to evaluate the contribution of approved dosages of ranolazine (R) to the relief of AF paroxysms in patients receiving infusion therapy with amiodarone (A).
The present study includes 133 patients. (66±10 years, 42% of men). All included patients developed paroxysmal atrial fibrillation that lasted less than 48 hours before amiodarone infusion. All patients had no contraindications for pharmacological cardioversion. All patients received an intravenous bolus of amiodarone 5 mg/kg followed by a continuous infusion of 50 mg/h. Amiodarone infusion lasted up to 48 hours and stopped at the time of restoration of sinus rhythm. Immediately after the rhythm was restored, patients were switched to oral amiodarone at a dose of 200 mg/day.
The included patients were divided into 3 groups, the 1st group (group A, 44 patients) received only amiodarone according to the protocol, the 2nd group (group P500+A, 42 patients) received 500 mg of ranolazine orally at the time of administration of the amiodarone bolus and it continued to be taken orally every 12 hours at the same dose (500 mg), 3rd group (group P1000+A, 47 patients) received 1000 mg of ranolazine orally at the time of administration of the amiodarone bolus and it continued to be taken orally every 12 hours at the same dose (1000 mg). Patients were not randomized into groups, but subsequent analysis showed that the patients had no significant differences in their demographic and clinical characteristics. The ECG was monitored throughout the infusion, and the moment of rhythm recovery was necessarily recorded on the ECG. Three time lags were identified (the first 12 hours, i.e. before taking the 2nd dose of ranolazine, the first 24 hours, i.e. before taking the 3rd dose of ranolazine and 48 hours). 
During the first 12 hours in group A, rhythm recovery occurred in 36% of patients, in the P500+A group, rhythm recovery occurred in 64% of patients (p = ,0177 between A and P500+A according to the Chi-square test), in the P1000+A group the rhythm was restored in 72% of patients (p=,0012 between A and P1000+A according to the Chi-square test). During the first 24 hours, the restoration of sinus rhythm occurred in groups A, P500+A and P1000+A in 66%, 83% (p=,1087 between A and P500+A according to Chi-square test) and 87% (p=,0305 between A and P1000+A according to the Chi-square test), respectively. After 48 hours, rhythm recovery was noted in 77%, 93% (p=,0862 between A and P500+A by Chi-square), 98% (p=,0071 between A and P1000+A by Chi-square) in groups A, P500+A and P1000+A. During the infusion of A and taking P, no significant side effects were noted.
In this study, the addition of ranolazine to amiodarone was safe and well tolerated, and was more effective than amiodarone. The combination of the maximum allowed dose of ranolazine 1000 mg every 12 hours with amiodarone infusion already in the first 12 hours of use shows the maximum efficiency - 72% restoration of sinus rhythm, which reaches 98% by 48 hours, significantly exceeding amiodarone monotherapy at all-time intervals with comparable tolerability. The use of a lower dose of ranolazine 500 mg every 12 hours with amiodarone infusion is significantly superior to amiodarone monotherapy at the beginning - in the first 12 hours and at the end - by 48 hours and can be recommended in case of individual intolerance to the maximum combination of P+A.

Congenital heart defects (CHDs) are the most common malformations. In children, in the structure of all malformations, CHD occurs in 30% of cases and is one of the most common causes of death in young children, and 5-8% of all CHD is Fallot's tetralogy.
According to the International Classification of Diseases of the 10th revision, there is Q 21.3 Tetralogy of Fallot - a ventricular septal defect with stenosis or atresia of the pulmonary artery, aortic extraposition, and right ventricular hypertrophy. The first reports of vice belong to M. Stensen (1673). A.A. Kisel (1887) was the first to carry out an intravital diagnosis of the defect. The French doctor Eyeppe-Louis Arthur Fallot (1888) introduced the term "tetralogy" (tetralogy) for the clinical designation of the four components of the "blue" disease. The clinic of Fallot's tetrad can be different, due to the variability of hemodynamic disorders. The severity of hemodynamic disorders and the severity of the defect are primarily determined by the degree of narrowing of the pulmonary artery, which can range from slight stenosis to complete atresia. The tetrad of Fallot is characterized by a high large ventricular septal defect (perimembranous subaortic) and aortic extraposition, that is, the displacement of the aortic orifice to the right so that it “sits astride” the interventricular septum, and from the right ventricle there is a direct exit into the aortic lumen. Thus, two blood streams enter the aorta - from the right ventricle (venous) and the left ventricle (arterial). The fourth sign of defect is right ventricular hypertrophy, which is a secondary compensatory component. The condition of a child with Fallot's tetrad progresses each time without surgical correction. Currently, there is a global trend of early surgical treatment. Pediatric cardiac surgeons talk about the need to operate during the first year of life. In our study, we want to talk about the importance of this operation in the first year of life.

The combination of tuberculosis (TB) of the lungs and diabetes mellitus (DM) remains one of the urgent problems of modern phthisiology. Treatment of pulmonary TB in patients with DM is a difficult task due to the complications of DM [3]. At the same time, against the background of a violation of metabolic processes caused by hyperglycemia, lesions of various organs and systems of the body occur [1, 3]. The presence of complications of diabetes increases the risk of developing adverse reactions (ARs) to anti-tuberculosis drugs (ATDs), which reduce the effectiveness of treatment of patients, limiting the possibility of a full and continuous course of chemotherapy. Accordingly, the parallel treatment and management of a patient with pulmonary tuberculosis in combination with diabetes is quite difficult and problematic. Given this circumstance, the authors considered it necessary to share their clinical experience with a wide range of TB doctors.

The history of the Department of Psychiatry and Narcology is closely intertwined with the foundation of the university in 1992 of the Kazakh-Russian Medical University, against the background of political and economic reforms and changes, which is still one of the largest private universities in the country.
Initially, the departments were divided into large and small subjects, large ones were an association of many small subjects, which was no exception to the Department of Psychiatry and Narcology, which was the subject of the Department of Neurology.
The article contains information about the history of the development of the Department of Psychiatry and Narcology, and also examines the scientific path of its heads. The process of transformation of the department into an independent unit is shown and the main trends of its development at the present stage are highlighted. Currently, the Department of Psychiatry and Narcology is fully staffed with highly specialized teachers who train students of all faculties of the Kazakh-Russian Medical University in obtaining higher and postgraduate education that fully meets the requirements of the Ministry of Health.