Relevance. Unilateral paresis of the vocal folds is a common complication after thyroidectomy, accompanied by impaired phonation, breathing, and decreased quality of life.

Goal. To evaluate the effectiveness of a comprehensive rehabilitation technique, including amplipulse therapy, DoctorVox voice therapy, and drug electrophoresis in patients with unilateral vocal fold paresis.

Methods. The study included 132 patients (18-65 years old) with unilateral paresis of the vocal folds after thyroidectomy. The rehabilitation program included amplipulse therapy (10 sessions), voice therapy (4-6 weeks) and electrophoresis (2-3 weeks). The effectiveness was assessed on the VHI-10 scale, acoustic parameters (Jitter, Shimmer, HNR, MPT), laryngostroboscopy. Statistical processing was performed in SPSS 26.0, the significance level is p<0.05.

Results. 76 % of patients showed an improvement in vocal function; in the 18-35 – year-old group, the positive dynamics was 85 %, in the 36-65-year-old group – 70 % (p while HNR and MPT increased. The average VHI-10 score decreased from 45.3±5.1 to 22.4±4.0 (p<0.01).

Conclusions. The complex technique helps to improve voice function after thyroidectomy and can be recommended for implementation in clinical practice. Further multicenter studies with the inclusion of a control group are required.

The assessment of patient care challenges and satisfaction at the hospital level, based on the opinions of medical staff, is crucial in Kazakhstan. It addresses key issues related to healthcare quality and accessibility, particularly within specialized fields like gynecology, which directly impact patient outcomes and the overall efficiency of the healthcare system.

Aim. The study aimed to assess the challenges the patients face when receiving medical care at an inpatient gynecology department.

Materials and methods. The cross-sectional study was conducted in the first half of 2024, with a survey specifically developed for hospital gynecologists. The research was conducted with the support of the Almaty City Health Department and the leadership of medical organizations. Participation was voluntary and anonymous, and respondents had the flexibility to complete the survey at their convenience.

Results. The survey identifies key challenges, including personnel shortages (36.1% at the primary healthcare level and 29.6 % at the hospital level), insufficient diagnostic examinations (25.9 %), and inadequate equipment (38.1 % of gynecologists). Despite these issues, 66.7 % of respondents rated medical care as accessible, and 40.7 % qualified, with a third of doctors and half of nurses noting increased services over the past year. Additionally, 38.9 % rated the feedback system excellent, and 63.0 % would recommend this hospital, reflecting a generally positive care assessment.

Conclusion. The survey reveals challenges such as personnel shortages, insufficient diagnostic services, and high costs, which affect patient care at the hospital. Despite these issues, most respondents view the range of services and accessibility positively, with many willing to recommend the hospital to others.

Obesity is a growing public health concern worldwide, and Kazakhstan is no exception to this trend. The quality of medical care plays a critical role in how effectively obesity is managed and treated. This study set out to explore how satisfied obese patients are with the medical services they receive in a primary healthcare setting.

To gather insights, a survey was conducted involving 377 individuals with obesity, all registered at the polyclinic in Almaty. The questionnaire aimed to capture the social and demographic characteristics of the respondents, their views on the quality of medical care provided, and the perceived usefulness of the advice they received. The data were analyzed using descriptive statistics and tests to uncover significant patterns and correlations.

The study results showed that the majority of patients (85.4 %) were satisfied with the organization of medical care. Among the respondents, 78.5 % received recommendations on weight reduction, and 72.3 % of them found these recommendations useful. Additionally, 71.1% had access to specialists such as a healthy lifestyle doctor or a psychologist. Some patients (35.7 %) faced situations where their health problems were attributed solely to excess weight without additional examinations.

The study results can serve as a foundation for developing more effective strategies in the prevention and treatment of obesity.

Relevance. Multiple sclerosis is a complex chronic autoimmune disease of the central nervous system, accompanied by the destruction of myelin and impaired transmission of nerve impulses. Diagnosing MS remains a difficult task, especially in light of the need to differentiate from other diseases. Even if there is a suspicion of multiple sclerosis, the new criteria require proof of the dissemination of foci in space and time, as well as the exclusion of other pathologies.

Goal. To review our experience of integrating the updated diagnostic criteria for multiple sclerosis in 2024 into the clinical practice of a specialized office in Almaty.

Methods and materials. The features of the application of modern diagnostic methods are described, including the use of magnetic resonance imaging, analysis of biomarkers (for example, free kappa-light chains - k–FLC), optical coherence tomography and assessment of the central venous sign.

Results. The article presents clinical cases reflecting diagnostic difficulties and emphasizing the importance of modern approaches to improve diagnostic accuracy and timely initiation of treatment. The need for comprehensive and individualized patient management was noted, contributing to an improvement in prognosis and quality of life.

Conclusions. It is necessary to continue developing the diagnostic capabilities of specialized multiple sclerosis rooms, as well as strengthen the training of specialists in order to improve the quality of medical care.

Suicide is a critical public health issue with far-reaching societal impacts. It causes profound emotional distress for families, significant economic losses from reduced productivity, and escalating healthcare costs. Despite its gravity, suicide remains inadequately addressed in many regions, with key metrics, such as years of lost working life (YLL), often uncalculated.

Objective of the research. To study the prevalence rate of suicides and suicide attempts among minors according to statistical reports available for the research.

Methods and materials: The object of the research is the child population of the Republic of Kazakhstan (age: up to 18 years) exposed to suicidal behavior (suicides and suicide attempts). Data for research: statistical data of the Official website of the Committee on Legal Statistics and Special Records of the General Prosecutor's Office of the Republic of Kazakhstan «Information on criminal offenses, perpetrators, on the work of criminal prosecution authorities and committed suicides» over the periods from 2017-2024 were used.

Results: Analysis of available statistical data has shown the need to create an integrated database with indicators that maximally reflect the complex of biopsychosocial problems of auto-aggressive destructive behavior among minors. It is necessary to develop and implement an integrated database that reflects all aspects of suicidal ideation in the child population with mental disorders and illnesses.

Discussion.Development and implementation of an integrated database will make it possible to plan the training of specialists in child psychiatry and child medical psychology.

Conclusion.Use of developed algorithms and models based on machine learning can be used to create tools that allow specialists working in the field of children's mental health to conduct more accurate and rapid diagnosis of suicidal tendencies in children, effectively develop algorithms for prevention programs and interventions that take into account individual and regional peculiarities.

The paper examines the impact of occupational risk factors in the mining industry on workers’ health and recognizes methodologies and tools for mitigating or eliminating these risks. Reducing the harmful impact of the mining industry is being studied and monitored globally. According to the International Organization for Safety and Health at Work, about 2.8 million people die annually as a result of workrelated accidents or occupational diseases. Additionally, around 374 million people suffer from various injuries and illnesses at the workplace each year. The issues of occupational diseases and industrial injuries are also relevant to the mining industry in Kazakhstan.

Objective. To study the literature data on the impact of occupational factors on the health of workers in a mining enterprise and the international experience of measures to reduce the harmful effects of the working environment in this industry at the present stage.

Materials and methods. The studies and publications on the study topic were analyzed using sources indexed in electronic databases such as e-Library, Google Academy, PubMed, Web of Science, and Scopus.

Results. An integrated approach to reducing the effects of exposure to harmful factors in the mining industry’s production environment yields positive results.

The results of a literature review on studying occupational diseases and injuries among workers in the mining industry are presented. The features of measures to mitigate the risk of hazardous working conditions in different countries are listed.

Conclusions. A comprehensive approach to control and minimize the consequences of harmful occupational factors in the mining industry has shown positive outcomes. According to the latest data, tobacco smoke is one of the deadly risk factors for deaths in the world. This is an additional approach to existing tobacco control measures.

The economic burden of diabetes is particularly evident in low- and middle-income countries, where patients often have to cover healthcare expenses out of pocket. Analysis shows that diabetes-related costs vary significantly depending on a country's income level, with expenditures being extremely high in the United States. Attention is also drawn to differences in the structure of costs: in poorer countries, the main expenses are related to medications, whereas in wealthier countries, a significant portion of spending is allocated to treating complications. Special emphasis is placed on the economic consequences of diabetes complications, such as cardiovascular diseases, retinopathy, and amputations.

Objective. To highlight the importance of early detection and preventive measures in reducing the economic burden associated with diabetes.

Materials and Methods. This article is based on a literature review conducted using PubMed, EMBASE, EconLit, and IBSS databases. Epidemiological and economic data from 184 countries were used to assess the global economic burden of diabetes, regardless of its type.

Conclusion. The study results demonstrate that the economic burden of diabetes is steadily increasing and may exceed USD 1 trillion by 2035. This issue is particularly relevant in low-income countries, where 75% of treatment costs fall on patients themselves, limiting access to healthcare, leading to late diagnosis of diabetes, an increase in the number of complications, and a rise in financial costs.

Relevance. The well-being of children and adolescents in any society, under any social, economic and political conditions, is an urgent problem and a priority task, as it determines the future of the country and the gene pool of the nation. In modern times, children's health is affected by a whole range of adverse factors, among which the most significant roles belong to various environmental pollutants, poor nutrition, social and economic instability in the family, which leads to a deterioration in the physical health of children and adolescents, an increase in the prevalence of functional abnormalities and chronic diseases. From these positions, the state of health of children and adolescents of school age causes reasonable concern to doctors. Improving preventive measures to prevent morbidity remains relevant today.

The purpose of this study was to study approaches in the organization, financing, evaluation of indicators, as well as similar frequency during preventive medical examinations of children in the CIS countries.

Materials and methods. The literature search was conducted using reliable databases such as PubMed, Google Scholar, Scopus, and ScienceDirect. Evidence-based publications and articles published in these databases were reviewed. The list of references allowed scientific papers whose publication date was in the range 2006-2023.

Results. As a result, it was found that preventive medical examinations of children in the CIS countries have similar approaches in organization, financing, evaluation of indicators, as well as similar frequency. Differences in approaches to preventive examinations between the CIS and European countries have been identified, including the different frequency of examinations, the list of mandatory medical tests, and the level of involvement of parents and schools in the process of monitoring children's health.

Conclusions. It is noted that in a number of countries, preventive examinations include modern diagnostic methods such as mental health screening, assessment of physical activity levels and detection of early signs of chronic diseases.

Worldwide, millions of people need emergency ophthalmologic care due to eye injuries, acute inflammatory diseases, sudden visual disturbances and other emergency conditions. Shortage of specialists, insufficiently equipped medical institutions and uneven distribution of ophthalmologic care create significant problems in its availability, especially in low-income regions.

Purpose of the study: to investigate the organization and problems of emergency ophthalmic care in the world.

Materials and Methods: A comprehensive literature review was conducted using PubMed, eLibrary, and Google Scholar databases covering the topics of ophthalmic emergency care, disease prevalence, new technologies, and shortages of specialists. Articles published between 2014 and 2024 in Russian, English and Kazakh were selected. Three experts independently analyzed the articles, and WHO data were used to analyze trends. The quality of articles was assessed using international checklists.

Results. Ophthalmologic emergencies vary worldwide, common diagnoses include ocular trauma, conjunctivitis, and corneal trauma. Ocular trauma, especially non-penetrating corneal trauma, foreign bodies and chemical burns were frequently reported in studies conducted in the US, Saudi Arabia and Kazakhstan. In addition, demographic factors such as age, gender, and region influenced the frequency of visits, with males and those living in rural areas more likely to seek emergency care. Eye trauma remains the leading cause of hospitalization in several countries.

Conclusions. Emergency ophthalmologic care worldwide shows variations in conditions, age, gender, and regions. Eye trauma, conjunctivitis and corneal injuries are common. Critical issues include staffing, equipment shortages, and the need for better training and access to care to better respond to emergencies.

Autoimmune hepatitis is an immune-mediated inflammatory liver disease of unknown etiology that can affect individuals of any age, gender, or ethnicity. The incidence among the adult population varies between 0.67 and 2 per 100,000 people, depending on geographical location.

Autoimmune hepatitis primarily affects young, working-age individuals and follows a steadily progressive course. At the time of seeking medical attention, approximately one-third of adults and half of children already have severe fibrosis or liver cirrhosis, which in turn increases the rates of disability and mortality.

The aim of the study was to reflect current data on clinical and immunological features and the analysis of factors affecting the effectiveness of immunosuppressive therapy in patients with autoimmune hepatitis worldwide.

Methods and materials. The English–language publications in the PubMed, Google Scholar and Google Academia databases for the period from 1993 to 2024 were analyzed.

Results. The identification of prognostic factors of an unfavorable course of AH plays a crucial role in optimizing therapy: clinical predictors, laboratory markers, concomitant diseases.

Conclusions. This literature review reveals key aspects in the treatment of autoimmune hepatitis and highlights the need for a personalized approach to therapy, taking into account prognostic factors and predictors of the effectiveness of immunosuppressive therapy.

The range of pharmacies is an important part of their business, as the quality of customer service and the economic efficiency of the pharmacy organization depend on its formation. The paper examines internal and external factors such as public demand, legislative changes, seasonal fluctuations, procurement and supply characteristics, the impact of competition and marketing strategies. The analysis reveals the main aspects that determine the optimization of the product range to increase competitiveness and customer satisfaction. Recommendations on effective assortment management have been developed for pharmacy organizations, which will improve their financial results and strengthen their market position.

The purpose of the research is to identify the most significant factors affecting the range of pharmacy products, as well as to propose methods and strategies for effective assortment management in modern market conditions.

Practical significance: the results of the study allow pharmacy organizations to plan their product range more accurately and efficiently, focusing on changing consumer preferences, seasonal fluctuations in demand, as well as current trends in the pharmaceutical market. This helps to increase customer satisfaction and improve financial results. Based on the analysis of external and internal factors such as supply, legislative changes and market trends, flexible and effective procurement management mechanisms can be proposed. This will help reduce the cost of storing surplus goods, avoid shortages of popular drugs, and increase business profitability.

Conclusions.The research work substantiates the importance of an integrated approach to the formation of a range of pharmacy products in Almaty. These recommendations can be used by pharmacy organizations for effective assortment management and adaptation to changes in the pharmaceutical market.