Long-term survival of patients undergoing myocardial revascularization with multivessel disease is associated with the completeness of coronary artery revascularization. This is largely true for patients with diabetes mellitus (DM).
The aim of this study was to evaluate the long-term overall and cardiovascular survival of patients after coronary bypass surgery (CABG) or percutaneous coronary intervention (PCI) with native multivessel disease in patients with diabetes mellitus compared with patients without diabetes.
Material and methods. A prospective non-randomized study included 1192 people with significant multivessel coronary artery disease who underwent CABG or PCI for this reason in 2018-2022. The choice of the revascularization method was determined by the decision of the cardioteam, which included a cardiologist, an X-ray surgeon, and a cardiovascular surgeon. 426 patients underwent CABG and 766 patients received PCI with coronary stent implantation. Of these, 25.5% (304 patients) had type II DM detected before intervention. Glycated hemoglobin (HbA1c) and PGS (Patient Glycemic Status) were determined before surgery in all patients with DM, fasting glycated hemoglobin was divided into < 6.5%, < 7.0%, < 7.5%, < 8, 0% and 8.0% and above. PGS was divided into less than 35, 35-100, 100-150 and above 150.
In all patients, before and after revascularization, the initial (iSS) and residual (rSS) SYNTAX score (SS) were determined. According to their levels, patients were divided into iSS less than 23, iSS 23-32 and iSS above 32. Postoperative calculation of rSS was also carried out: rSS=0 (complete revascularization) and rSS>0 (incomplete revascularization), and it was subdivided into rSS=1-4, rSS=5-8, rSS>8.
Results. Hospital survival in the CABG group was 99.5%, and in the PCI group 99.8% (P=NS). In the DM subgroup after CABG, in-hospital survival was 99.1%, and after PCI it was 99.4% (P=NS).
Long-term survival up to 4 years was 93.2% in the CABG group and 94.1% in the PCI group. Among patients with DM, the long-term survival up to 4 years was 81.0% in the CABG group, and 83.5% in the PCI group.
The level of glycated hemoglobin above 7.5% and PGS=100-150 became significant predictors of in-hospital survival for CABG and PCI by univariate and multivariate regression analysis with sequential inclusion of variables. PGS over 100 and rSS>8 were significant predictors of long-term survival up to 4 years in the CABG and DM group, and rSS>0 was significant predictor of longterm survival in the PCI and DM group.
Conclusions. The immediate (inhospital) survival in patients with coronary artery disease and diabetes is affected by the level of glycated hemoglobin above 7.5% and PGS=100-150. Long-term survival up to 4 years after CABG is affected by a high residual SYNTAX index (rSS>8) and poor glycemic status of the patient (GSP) 100-150, and survival after PCI in the same period is affected by any incomplete coronary artery revascularization (rSS>0).

In this article, we present the material of a retrospective analysis of the frequency of occurrence and prognostic role of certain morphological markers (tumor infiltrating lymphocytes (TILs), tumor emboli in the walls of vessels, invasion into the walls of vessels) in patients with a newly diagnosed breast cancer (breast cancer) who received treatment in the conditions of the Almaty regional Multidisciplinary Clinic (ARMK), depending on the age, stage of the disease and the phenotype of the tumor.

The article reflects the results of a study conducted on the inclusion of the halotherapy method in a comprehensive rehabilitation program for 68 patients of different ages and gender infected with coronavirus infection, as well as an assessment of its effectiveness. We selected 68 patients with coronavirus infection and randomly divided them into two groups. Main group (n=38) and control group (n=30). Patients of the main group underwent complex rehabilitation and halotherapy, and patients of the control group underwent complex rehabilitation without halotherapy.

The article presents the results of a dental examination of patients with endoperiodontal syndrome for an effective diagnosis. With a combined lesion of the periodontal and endodontal, there are difficulties in assessing the primary lesion, choosing a treatment method and achieving positive treatment results. The study will help practitioners in organizing, planning such patients, choosing treatment tactics to achieve efficiency and create long-term remission.

In the simulation center of the Kazakh-Russian Medical University (Almaty), the experience of using obstetric simulators for teaching and practicing students practical skills, their importance in the learning process, and the impact on the acquisition of general skills in obstetrics and gynecology were considered. The role of medical mannequins in medical education centers is mentioned, what opportunities they provide to teachers and students. Most importantly, by practicing the practical skills of students in the simulation center, it helps students feel confident when working with patients. Students are under the strict supervision of the teacher during the implementation of practical skills using obstetric simulators and have the opportunity to repeat the same skills several times. In addition, a survey was conducted among the students, information was obtained about their needs during their studies.

Granulomatosis with polyangiitis (GPA or Wegener's granulomatosis) is a rare systemic autoimmune disease of unknown etiology characterized by granulomatous inflammation, tissue necrosis, and vasculitis of small to medium-sized vessels. Respiratory tract involvement is the most common, affecting up to 85% of patients, followed by the renal system in 75% of patients, with Wegener's granulomatosis ocular involvement estimated to occur in 50 – 60% of patients. Damage to the organ of vision can not only significantly reduce the quality of life of the patient, but in rare cases lead to severe complications, including death. The article describes a clinical case of a 51-year-old woman who suffered from end-stage chronic kidney disease, polysegmental pneumonia with signs of destruction and necrotizing scleritis.

Mobius syndrome is a rare pathology of the nervous system, which is presented by an anomaly in the structure of the cranial nerves. For the first time, the pathology was described by the neurologist Paul Möbius and to this day is a poorly understood anomaly. There are several theories of the development of this syndrome, but none of them is recognized as dominant. Therefore, Mobius syndrome is considered as a multifactorial syndrome. Precise diagnostic criteria for this syndrome do not exist, and the inconsistency of associated features makes identification difficult. This article provides a description of two clinical cases of this rare syndrome, which in turn will help the practicing neurologist to better verify this syndrome.

Uncontrolled hemorrhage can become a life-threatening injury in less than five minutes. The aim of this work is to make an overview of perspective technologies for creation of the gel for stopping massive hemorrhage. Biopolymers are natural compounds that comprise several polysaccharides and polypeptides. Because of their distinct molecular structure and bioactivity, they have piqued the curiosity of biomedical researchers and demonstrated a high potential for therapeutic change. Biopolymers have demonstrated superior biodegradability, dependable biocompatibility, and non-exothermic reactivity in first-aid hemostasis when compared to synthetic polymers and inorganic hemostatic materials. Given the growing importance of biopolymer functionalization, we examined the modification of polymers based on their functional designs, such as bioadhesion, charge stimulation, and the inclusion of procoagulant functional groups and ions. The numerous studies have demonstrated the excellent hemostatic effect, it is still necessary to further investigate how different kind of the materials affect the hemostatic process. The hemostatic materials' clinical transformation lags behind their basic research. In general, materials with few, basic components are better for transformation, but this has increased the need for careful planning in their design. Finally, the molecular structures and forms of hemostatic materials should receive more consideration during design. It is important to thoroughly investigate how the components interact with the coagulation process. It is anticipated that appropriate designs for hemostatic materials will enable rapid development from the lab to the patient bed.

The review used 61 literature sources on the new anti-tuberculosis drug PA-824-pretomanid, which exhibits antimicrobial activity against strains of drug-resistant Mycobacterium tuberculosis. According to the studied data, combinations of pretomanid with other chemotherapy drugs are highly effective and promising in the treatment of patients with drug-resistant tuberculosis.

This literature review provides information on the impact of the new coronavirus infection (COVID-19) on possible complications from the reproductive system, on the course of pregnancy, the risk of transmission of the SARSCoV-2 virus from mother to fetus, the choice of delivery method, and the importance of vaccination during pre – gravid preparation. Particular attention is paid to complications during pregnancy: with coronovirus infection, premature births are more common, premature babies are born with low body weight, and the frequency of caesarean section is higher. In addition, during pregnancy, there is an increased susceptibility to developing hypertension and gestational diabetes mellitus, which are now recognized risk factors for the development of severe acute respiratory syndrome caused by coronaviruses, including SARS-CoV-2. However, there are still insufficient data to assess the impact of SARS-CoV-2 infection on the health of pregnant women and newborns. The main aspects of international professional communities such as the Royal College of Obstetricians and Gynecologists of Great Britain, the Joint Com mittee on Vaccination and Immunization.

Prion diseases are diseases associated with pathological proteins and based on a protein with an abnormal tertiary structure. Prions are a special class of infectious pathogens that do not have nucleic acids in their composition. They have been found in a wide range of mammalian species, including humans. Human prion diseases can occur sporadically, be hereditary or acquired. Sporadic human prion diseases include Creutzfeldt-Jakob disease (CJD), fatal insomnia, and prionopathy sensitive to various proteases. Acquired human prion diseases account for only 5% of human prion disease cases. These include chicken, iatrogenic CJD, and a new variety of CJD that has been transmitted to humans from affected cattle by eating meat, especially the brain. This review provides information about the history of discovery, the structural structure and mechanism of reproduction of the prion, types of prion diseases.

This article discusses the common problems of the cardiovascular system that have developed and appeared in connection with the global Covid-19 pandemic, as well as their causes and preventive and treatment measures. Myocarditis caused by Covid-19, etiology, clinic, methods of diagnosis and treatment. The manifestations and symptoms of tachycardia in Covid-19 will be analyzed, as well as the causes of thrombosis and their prevention.

Tuberculosis (TB) is a serious infectious disease that has affected humans for centuries. The treatment of TB has evolved significantly over the years, from the use of sanatoriums as the primary treatment method to the introduction of antibiotics and the emergence of personalized medicine. Sanatoriums were popularized in the late 19th and early 20th centuries but were limited in their accessibility and cost. The discovery and development of antibiotics, such as streptomycin and isoniazid, led to the widespread adoption of antibiotics as the primary treatment for TB. Personalized medicine is a new approach that targets the specific needs of each patient through genotyping and individualized drug regimens. The future of TB treatment may lie in individualized, personalized approaches. This article is a literature review on the mentioned topic based on Case Studies.

This literature review examines the role of Ayurvedic medicine in the rehabilitation of stroke complications. Ayurveda offers a holistic approach to healthcare, which includes various treatment modalities such as massage, herbal medicines, and yoga. Several studies have shown the potential benefits of Ayurvedic methods in improving outcomes in stroke rehabilitation, including reduction of spasticity, improvement of motor function, and enhanced quality of life. However, more research is needed to fully understand the potential of Ayurveda in treating stroke complications. Overall, this literature review highlights the importance of Ayurvedic medicine as an adjunct therapy in stroke rehabilitation and its potential as a future treatment modality for stroke complications.

The emergence of pandemics highlights the fallibility of humans and underscores the need for communities to be prepared. In late 2019, the first reports of the coronavirus outbreak surfaced, and it has since been declared a global pandemic by the World Health Organization. Countries worldwide have responded to the virus outbreak in varying ways. Unfortunately, China and other major countries experienced delays in detection and response, resulting in an overwhelming burden on local health systems.