618.11-006.2-031-06:612.015.3]-055.2-085.874.2

The purpose of the study is to substantiate, based on a review of literary sources, the effectiveness of various types of diet therapy as an initial method of treatment in women with polycystic ovary syndrome and insulin resistance, their effect on the normalization of the menstrual cycle, correction of metabolic disorders and reduction of the level of insulin resistance. From 2018 to 2024 40 articles were analyzed with key words: polycystic ovary syndrome (PCOS), insulin resistance, diet therapy, Mediterranean diet, ketogenic diet, low-carbohydrate diet, low-fat diet, Homeostasis model assessment (HOMA) according to which a review of the available literature was conducted in PubMed, National Library of Medicine, Medscape. The study did not include pregnant, lactating women who took hormonal therapy and/or insulin sensitizers during the last 2 months, had liver, kidney, and heart diseases that failed local treatment of hirsutism, with congenital hyperplasia of the adrenal glands, androgen-secreting tumors, Cushing's syndrome. A review and analysis of studies on the effects of a ketogenic diet for 12 weeks, in which 14 overweight women with a diagnosis of polycystic ovary syndrome, participated. 40 articles were studied using bibliographic and analytical methods. At the beginning of the study patients had HOMA-IR above 2.5, which confirms insulin resistance. After using ketogenic diet, a significant decrease in the level of glucose, insulin, and, therefore, the HOMA index was observed. There were significant changes in lipid profiles with a decrease in triglycerides, total cholesterol, and low-density lipoproteins along with increases in high-density lipoprotein. Anthropometric measurements revealed a weight loss of 8.78 kg and a significant decrease in the body mass index of 3.18. A study of 72 women with PCOS showed a superior efficacy of a Mediterranean diet (MED) combined with a low-carbohydrate (LC) diet versus a low-fat diet alone. In patients who used the combination of MED/LC diet, in 86.7% of cases, the regular menstrual cycle was restored, and pregnancy occurred.

 УДК 222.11:241.7:613.2

Вступ. Сьогодні в духовному житті людини аксіомою є той факт, що від часу гріхопадіння Адама і Єви в Едемі певної еволюції в суспільному житті людей зазнало їхнє земне буття у бік поступового скорочення тривалости життя. З цієї причини й зроблено спробу науково з’ясувати такі складники тривалости життя людини на Землі, як спосіб життя та їстівні продукти у прабатьків людства Адама і Єви в Едемі. 
Мета. З’ясувати Господні настанови для родоначальників людства Адама і Єви про буття й харчування в Едемі як перший Божий варіант здорового способу життя і свідчення важливости цього для тривалости повсякденного життя і здоров’я людини в XXI сторіччі.
 Матеріали й методи. Виконано епідеміологічне одномоментне суцільне дослідження Святого Письма з використанням низки наукових епідеміологічних та  історичних методів дослідження з урахуванням принципів системности. 
Результати. З’ясовано, що для створених і поселених Господом Богом в Едемському саду перших людей Творець Всесвіту запровадив повсякденні настанови щодо проживання та їстівних продуктів, яких вони неухильно дотримувалися упродовж семи років. Визначений Богом зміст буття й харчування уможливив Адамові і Єві мати прекрасні духовні й фізичні сили, світлий розум, чисте серце і добру волю, проживати в гармонії з навколишнім рослинним і тваринним світом, бачити й спілкуватися із Всевишнім, який освічу вав і розвивав їхній розум та оберігав Своєю Благодаттю, а вони цілковито опановували Господні науки.
 Аргументовано, що порушення визначеного Господом способу життя через харчові продукти «стало наріжним каменем» у подальшому співіснуванні перших людей з Богом, що привело їх до гріхопадіння.
 Розгніваний такою поведінкою Адама і Єви Бог-Творець різко перемінив для них місце, стиль життя і спосіб харчування, прирікши їх і наступний рід людський на хвороби, старість і смерть, а також змінив і власний рукотворний об’єкт – сушу на середовища рослинного і тваринного світу.
 Висновки. Господні настанови родоначальникам людства Адамові і Єві в Раю про спосіб їхнього життя та їстівні продукти доцільно інтерпретувати в новітньому кризовому стані як індивідуального, так і громадського здоров’я як першу модель здорового способу життя для людини згідно з настановами Бога, де базисом для населення християнської держави Україна (67,9 % громадян вважають себе вірянами, 62,3 % – сповідують православ’я) зостається дотримання Божих заповідей. 
Ключові слова: Господь Бог, перші люди,  Божі настанови, їстівні продукти, перша модель здорового способу життя. 

Introduction. An axiom for current spiritual life of a person is the fact that since the fall of Adam and Eve in Eden, a certain evolution in the social life of people caused gradual shortening of their lifespan. With this regard an attempt was made to figure out which elements of lifestyle and edible products of mankind progenitors – Adam and Eve in Eden – influenced the  duration of human life on the Earth.
 The aim of the srudy. Clarification of God's instructions to the progenitors of mankind – Adam and Eve – about mode of everyday life and food consumption in Eden as God's first option for a healthy lifestyle and evidence the importance of these instructions for the duration of life and human health in the XXI century.
 Materials and methods. The epidemiological, one-time, continuous study of the Holy Scriptures was carried out using several scientific, epidemiological, and historical research methods, taking into account the principles of systematicity. 
Results. It was found out that for the first people created by the Lord God, who were settled in the Garden of Eden, the Creator of the Universe established daily guidelines for living and edible products, which they consistently followed for seven years. 
The mode of life and nutrition standards established by God allowed Adam and Eve to have excellent spiritual and physical strength, bright mind, pure heart, and good will, to live in harmony with the surrounding plant and animal world, and to be able to see and communicate with God, who enlightened and developed their mind and protected them with His grace, and they completely mastered the Lord's sciences.
 As revealed the violation of the mode of life established by the Lord through food products “became the cornerstone” in the further coexistence of the first people with God, which led them to fall into sin. 
It is argued that when God, the Creator of the Universe, angered by such behavior of Adam and Eve, drastically changed their location, lifestyle, and way of food consumption, dooming them and the next human race to disease, old age, and death. The Creator of the World also changed his own man-made object – land – on the environment of the plant and animal world.
Conclusions. The Lord's instructions to the mankind progenitors – Adam and Eve in Paradise – about mode of their living and edible products should be interpreted taking into consideration modern crisis of both individual and public health as the first model of a healthy lifestyle for a person according to the instructions of God. Regarding Ukraine, the Christian country, 67.9 % citizens of which consider themselves believers, and 62.3 % profess Orthodoxy, the observance of these commandments of God remains crucial obcion.
 Keywords: God, the first people, God's instructions, edible products, the first model of a healthy lifestyle

Introduction 
Tuberculosis (TB) remains one of the leading  causes of death from infectious diseases in the world. The 
situation is complicated by the increasing prevalence of multidrug-resistant forms of the pathogen Mycobacterium 
tuberculosis against the background of covid, post-covid, long-covid disorders, which requires improving 
approaches to pharmacotherapy according to the requirements of ICD-11. According to the World Health 
Organization, more than ten million new cases of tuberculosis are registered in the world annually, while 
about one million three hundred thousand patients die [15]. Standard treatment of active tuberculosis, 
recommended by the World Health Organization, involves the use of a combination of at least three or four anti
tuberculosis drugs. This approach allows you to effectively combat the bacterial load, reduce the risk of developing drug resistance, shorten the duration of therapy, and reduce the frequency of relapses of the disease [6]. 
Fixed-dose combination drugs, which contain several active pharmaceutical ingredients in one dosage form, are designed to increase patient adherence to treatment and prevent dosing errors. These drugs are particularly relevant in countries with high tuberculosis incidence rates, where non-adherence to treatment regimens is common. Numerous studies have shown that fixed-dose combination drugs provide efficacy and safety comparable to single drugs, and reduce the risk of drug resistance [7, 8]. However, the use of fixed-dose combination 
drugs has certain limitations. Among patients with human immunodeficiency virus co-infection, pharmacokinetic 
interactions between anti-tuberculosis and antiretroviral drugs are possible. This can lead to changes in the 
concentration of active substances in the blood, reduced treatment efficacy, or increased toxicity [9]. In addition, 
the use of fixed-dose combination drugs may be inappropriate in cases of individual intolerance to one of 
the components or if dosage adjustment is necessary for a particular patient. Thus, despite the advantages of fixed-dose combination anti-tuberculosis drugs, their use requires an individual approach and constant monitoring of the effectiveness and safety of therapy. The rational use of such drugs in national tuberculosis control programs is a key factor in the successful control of this global health problem [10]. Overcoming multidrug-resistant tuberculosis is a challenging task, as the bacteria that cause this infection can develop resistance to standard anti-TB drugs. However, combination antimycobacterial chemotherapy remains the mainstay of treatment. It involves the use of at least three anti-TB drugs to which the bacteria are still susceptible, and the duration of treatment is at least 6 months [11, 12]. The main principles of anti-TB chemotherapy are: 
• Combination use of anti-TB drugs: The use of several drugs simultaneously reduces the risk of the development 
of resistance of TB bacteria to one of the drugs. 
• Use of standard drug combinations: Certain combinations of anti-TB drugs are defined as standard and 
are used to treat patients with new cases of TB and relapses of the disease. 
• Monitoring by healthcare professionals: Healthcare professionals should ensure that patients take their 
medications correctly and adhere to their treatment regimen. 
• Avoid adding one anti-TB drug after treatment failure: If a patient does not respond to treatment, adding another anti-TB drug to the regimen may lead to further failure. In addition, antimicrobial therapy is administered 
under the supervision of healthcare professionals, which allows for monitoring of drug use and prevention of 
potential complications. 
Regarding the convenience of taking medications, the development of combination drugs that contain the 
active pharmaceutical ingredients necessary for pharmacotherapy can help patients to facilitate their treatment regimen, improve adherence to the therapy protocol, and ensure the quality of the drugs [12]. Overall, the fight against multidrug-resistant tuberculosis requires a comprehensive approach, active collaboration between healthcare professionals and patients, as well as continuous improvement of anti-TB strategies and the development of new drugs to treat this dangerous infection. The purpose of the study was to conduct a content 
analysis of the modern range of combined anti-tuberculosis drugs registered on the pharmaceutical market of Ukraine, considering the current requirements of domestic legislation in the field of healthcare. Particular attention is paid to the study of the clinical feasibility of using fixeddose combination drugs in the pharmacotherapy of 
tuberculosis in accordance with the provisions of the sixteenth edition of the State Formulary of Medicines, 
approved by the Order of the Ministry of Health of Ukraine dated March 12, 2024 No. 418 “On Approval and 
Implementation of the Sixteenth Edition of the State Formulary of Medicines”. The work also analyzed current 
scientific sources on the effectiveness, safety, and impact of combined anti-tuberculosis pharmacotherapy on 
reducing the level of chemoresistance and increasing patient adherence to treatment.   
Materials and methods The study is of a content analysis nature and is based on a comprehensive study of open information sources related to combined anti-tuberculosis drugs. The main information resources were: scientific publications from professional domestic and international medical and pharmaceutical journals, official documents of the World Health Organization, analytical materials of international initiatives to combat tuberculosis, as well as current regulatory legal acts of Ukraine in the field of health care. The analysis of the range of combined anti
tuberculosis drugs registered in Ukraine was carried out using data from the State Register of Medicines of Ukraine. Particular attention was paid to drugs included in the sixteenth edition of the State Formulary of Medicines, approved by the Order of the Ministry of Health of Ukraine dated March 12, 2024 No. 418 “On Approval and Implementation of the Sixteenth Edition of the State Formulary of Medicines”. International non-proprietary names of active pharmaceutical ingredients, trade names of medicines, release forms, dosages, as well as their availability in state reimbursement programs were studied. In the process of research, methods of content 
analysis of scientific literature, comparative analysis of regulatory sources, classification method, as well as 
elements of a statistical approach for quantitative assessment of the presence of combined drugs on the 
pharmaceutical market of Ukraine, previous studies of foreign and domestic scientists in the direction of content 
analysis, quality of drugs [13-20] were applied. Special attention was paid to comparing data on the advantages and disadvantages of combination therapy in the context of international and national clinical guidelines, [21-23]. 
The research of the article is a fragment of research works of Private Scientific Institution "Scientific 
and Research University of Medical and Pharmaceutical Law" and Danylo Halytsky Lviv National Medical 
University on the topic "Diagnosis, treatment, pharmacotherapy of inflammatory, traumatic and onco
thoracic pathology using instrumental methods" (state registration number 0125U000071, implementation period 
2025-2031); Lviv Medical Institute on the topic of "Improving the system of circulation of drugs during 
pharmacotherapy on the basis of evidentiary and forensic pharmacy, organization, technology, biopharmacy and 
pharmaceutical law" (state registration 0120U105348, implementation period 2021-2026); Private Scientific Institution "Scientific and Research University of Medical and Pharmaceutical Law" on the topic “Multidisciplinary research of post-traumatic stress disorders during war among patients (primarily combatants)” (state registration number 0124U002540, implementation period 2024-2028). 

 УДК 314.8:(330+355.1)](477)

 Мета: встановлення характерологічних особливостей у природному русі населення України за 30 років незалежності (1991–2021) як основному індикаторі процесу відновлення людського ресурсу для економіки та Збройних сил держави.
 Матеріали і методи. Виконано епідеміологічне, одномоментне, суцільне дослідження з використанням біостатистичних даних бази Державного комітету статистики України за 1991–2021 рр., із застосуванням для аналізу комп’ютерного пакета Microsoft Office Excel (2021) та низки наукових медико-біостатистичних методів з урахуванням принципів системності.
 Результати. Аргументовано, що природний рух населення в країні за період в 30 років незалежності характеризується такими своєрідностями, як «демографічний перехрест» (1991), що визнається отриманими біостатистичними даними щорічного медіального скорочення числа народжень на М=-14 320±120 епізодів (1991 р. – Р=12,1 ‰ і 2021 р. – Р=7,3 ‰) та збільшенням чисельності смертей (1991 р. – Р=12,9 ‰ і 2021 р. – Р=18,5 ‰) з осередкованим, упродовж кожного року, наростанням кількості померлих на n=22 663±151 випадок, 
тоді як величина природного приросту серед людності країни у простежуваний проміжок часу є негативною та має спрямування до збільшення за Тпр  у Р=10,3 раза (1991 р. – Р= -0,8 ‰, тоді як у 2021 р. – Р=-11,2 ‰).
 Висновки. Висліди достеменно посвідчують наявність демографічного перехресту у стані природного руху населення та його пагубного наслідку – депопуляції, що призводить в суспільстві до систематичного зменшення абсолютної чисельності людності та зниження процесів відтворення населення (кожне наступне покоління чисельно менше за попереднє!), з причини чого і відбувається в Україні «старіння нації».
 Архіактуальним на сьогодні в питанні відтворення населення є безкомпромісне виконання заходів міністерствами, іншими центральними органами виконавчої влади, обласними, міськими держадміністраціями та органами місцевого самоврядування, що виходять зі «Стратегії людського розвитку» (2021), де «стратегічною ціллю № 1 є покращення медико-демографічної ситуації в Україні», що, власне, і засвідчує про пріоритетну увагу з боку держави до сфери людського розвитку як напряму забезпечення людським ресурсом економіки та обороноздатності держави. 
КЛЮЧОВІ СЛОВА: населення; чисельність; природний рух; демографічний перехід; народжуваність; смертність; природний приріст; депопуляція; стратегії людського розвитку; економіка; Збройні сили.

 Purpose: to establish characterological features in the natural movement of the population of Ukraine over the 30 years of independence (1991–2021) as the main indicator of the process of restoring human resources for the economy and the Armed Forces of the state.
 Materials and Methods. An epidemiological, one-time, continuous study was performed using biostatistical data from the database of the State Statistics Committee of Ukraine for 1991–2021, using the Microsoft Office Excel (2021) computer package for analysis and several scientific medical and biostatistical methods taking into account the principles of systematicity.
 Results. It is argued that the natural movement of the population in the country during the period of 30 years of independence is characterized by such peculiarities as the "demographic crossroads" (1991), which is recognized by the obtained biostatistical data of the annual medial reduction in the number of births by М=14320±120 episodes (1991 – Р=12.1 ‰ and 2021 – Р=7.3 ‰) and an increase in the number of deaths (1991 – Р=12.9 ‰ and 2021 – Р=18.5 ‰) with averaged, during each year, with an increase in the number of deaths by n=22663±151 cases, while the magnitude of natural increase among the population of the country in the observed period is negative and has a direction to increase according to Тincr
 by Р=10.3 (1991 – Р= -0.8 ‰, while in 2021 – Р=-11.2 ‰).
 Conclusions. The findings conclusively demonstrate the presence of a demographic crossroads in the state of natural population movement and its harmful consequence – depopulation, which leads to a systematic decrease in the absolute number of people in society and a decrease in the processes of population reproduction (each subsequent generation is numerically smaller than the previous one!), which is why the “aging of the 
nation” is happening in Ukraine.
 What is very relevant today in the issue of population reproduction is the uncompromising implementation of measures by ministries, other central bodies of executive power, regional, city-state administrations, and local self-government bodies based on the “Strategy of Human Development” (2021), where “strategic goal No. 1 is to improve the medical and demographic situation in Ukraine”, which, testifies to the priority attention of the state to the sphere of human development – as a direction of providing human resources for the economy and defense 
capability of the state. 
KEY WORDS: population; quantity; natural movement; demographic transition; birth rate; mortality; natural increase; depopulation; human development strategies; economy; Armed Forces.