Background: chronic cerebral ischemia is a common vascular pathology, the main etiopathogenetic mechanism of which is a progressive decrease in cerebral perfusion, leading to hypoxia of the nervous tissue and neuronal death. Chronic insufficiency of cerebral blood flow leads to the development of a number of symptoms that significantly reduce the quality of life of patients and gradually lead to disability. At the same time, along with the defeat of a number of areas of the brain, there is a destruction of prefrontal-subcortical connections that take part in the genesis of vascular cognitive impairment, the degree of which ranges from mild deficiency to dementia. The priority direction in assessing the severity of cognitive disorders in patients with chronic cerebral ischemia is to identify the initial forms of cognitive decline for the prevention of dementia. Positron emission computed tomography with fluorine-18-labeled glucose - 2(18F)-fluoro-2-deoxy-D-glucose, may be a promising method for detecting intellectual-mnestic disorders at the preclinical stage, allowing to evaluate metabolic and functional disorders of various structural parts of the central nervous system.
Design and methods: the sample consisted of 36 patients with chronic cerebral ischemia, who underwent a neurological examination, an assessment using the mini-mental state assessment scales, MOCA, and SF-36. Positron emission tomography with 18-fluorodeoxyglucose was also performed. All patients with chronic cerebral ischemia had cognitive impairment and reduced quality of life.
Results: according to positron emission tomography data, areas with hypoperfusion (prefrontal cortex, parietal and temporal lobes) were identified and correlated with manifestations of cognitive dysfunction. A correlation was also found between the severity of apractognostic disorders, mnestic disorders, and a decrease in perfusion in the anteroposterior parts of the parietal lobes and the left temporal lobe. Also found the relationship between the severity of intellectual dysfunction and the amount of damage to the nervous tissue.

In the modern world, pharmacy education plays an integral role in shaping future professional careers. Understanding the interests of students who have chosen a path in pharmacy becomes a key factor in providing quality pharmaceutical care in the future. This study aims to analyze the motivational factors influencing the choice of this profession and to study the dynamics of engagement at different stages of study.
Materials and methods. To achieve the set research goal, a sociological survey was conducted. The objects of the study were pharmacist students from 1st to 5th courses of the specialty «Pharmacy» of the NAO «Medical University of Karaganda».
The results of the study revealed that the most important motivations for choosing this specialty are the prestige of the profession, obtaining a diploma and the desire to benefit people. However, it is worth noting that students' interests can change at different stages of study. First-year students show more interest in acquiring knowledge, while senior students are more inclined to master the profession. The practical significance of this study is that the level of motivation of students has a direct impact on their professional training and ability to provide quality pharmaceutical services in the future.
Conclusions. The findings provide valuable information for further research and practical application in the field of pharmacy education. This contributes to a better understanding of student motivation and the adaptation of educational programs to their individual needs, providing better training for future pharmacists.

Despite the existing routine calendar of vaccination of children against measles, there was an increase in the incidence of measles in the post-covid period, with cases of severe course and mortality.
The purpose of this work is to determine the predictors of the measles clinic, indicating a worsening of the epidemiological situation of this infection.
Materials and methods. The cases of measles in patients hospitalized in the DGKIB in Almaty for 2023-2024 were retrospectively analyzed.
Results. An analysis of the epidemiological and clinical picture of measles in 2023-2024 showed that measles is currently registered in children of different age groups, with a predominance in I – 2103 (19 %), II – 3752 (34 %) and III – 3082 (28 %) age groups. Over the past 2 years, there has been a severe course of measles, especially in children of age groups I – 2059 (19 %), II – 3677 (34 %) and III – 3022 (28%). Boys – 4637 (54 %) cases are more common than girls – 3973 (46 %). The most common complications of measles are pneumonia, otitis media, diarrhea, and cases of meningitis and encephalitis have also been reported.
Conclusions. Severe forms of measles prevailed among children of groups I, II, III. The reason for the high incidence and severity was inadequate vaccination or lack thereof. Thus, it is necessary to strictly follow the vaccination schedule starting at 1 year and earlier for epidemic indications starting at 9 months of life. It is advisable to vaccinate risk groups - children with background diseases, malformations, chronic diseases, as well as children from preschool and school institutions.

According to the registry of the International Society of Heart and Lung Transplantation (ISHLT), approximately 5,000 heart transplantation are performed annually. Survival rates after heart transplantation are significantly higher compared to the natural course of terminal heart failure, as a result, transplantation activity has been increasing every year.
The article represents a clinical case of successful orthotopic biatrial heart transplantation to a recipient with end-stage heart failure, the peculiarity was the presence of a giant left atrium, the volume of which before the operation was 1070 ml, indexed volume 660 ml/m², long axis size 10.3 cm. Giant left atrium is a rare pathology characterized by excessive dilation of the cavity. According to literature data, the incidence of this pathology is 0.3%. Progressive left atrial dilatation was associated with the severe mitral regurgitation and atrial fibrillation in anamnesis. Description of the preoperative condition of the patient, features of surgical intervention and postoperative management of the patient. A dynamic assessment of the patient's condition was carried out throughout the year, including monitoring of laboratory parameters, instrumental investigations and functional tests.

Acute aortic dissection is often referred to as the «grand masquerade» due to the variety of clinical manifestations. Since clinical manifestations often include symptoms and signs associated with other diseases, such as acute coronary syndrome, cardiac arrhythmia, pulmonary embolism and stroke, the initial misdiagnosis of aortic dissection occurs in up to 34 % of cases.
We present a clinical case of a 54-year-old man with hypertension, whose clinical symptoms include chest pain and lower jaw pain combined with transient neurological symptoms and atrial fibrillation.
Transthoracic echocardiogram revealed dilatation of the ascending aorta and arch, membrane dissection in the ascending aorta. CT scan of the thoracic and abdominal aorta with contrast: Stanford type A and B aortic dissection.
The patient underwent the Bentall-de Bono procedure at the first stage with a positive effect.
Thus, timely differential diagnostics and instrumental studies improve clinical outcomes in aortic dissection.

The number of children with disabilities in the Republic of Kazakhstan is increasing every year. According to literary sources and statistical data, diseases of psychoneurological pathology rank first. Of particular concern is the dental health of children with cerebral palsy, as numerous data indicate that the prevalence of dental pathology in this group of patients remains extremely high.
Objective. To analyze literature data on the provision of dental care to children with cerebral palsy.
Materials and Methods. A literature search was conducted in the MEDLINE/PUBMED, Cyberleninka, and eLibrary databases to identify scientific works on the provision of dental care to children with disabilities. The following keywords were used: «disabled children», «dental care for children with disabilities», «cerebral palsy», «medical care for disabled people», «manifestation of chromosomal diseases in the oral cavity». Preference was given to original research and literature reviews. Filters were applied to include children and adolescents diagnosed with cerebral palsy under the age of 18 and full-text articles.

The article examines the use of PEST analysis as a tool for studying external factors influencing the development of training systems for pharmaceutical production personnel. This approach contributes to meeting state and international requirements in the pharmaceutical industry and enhancing companies' competitiveness. The study aimed to identify key political, economic, social, and technological factors and analyze their impact on the content, methods, and organization of training in pharmaceutical production. The research materials include regulatory documents, reports, and scientific publications, with the methodology based on PEST analysis. The results indicate that political factors, such as regulatory requirements, state policies, and standards, form the foundation for building and updating training systems by influencing their various elements. Economic factors determine the availability of financial resources for implementing educational initiatives and the influence of external economic conditions on the development of the employee training system. Social aspects influence the choice of training approaches and staff motivation, while technological factors expand the capabilities of training programs and emphasize the need for flexibility in training systems due to frequent changes in the pharmaceutical production sector. The study concludes that PEST analysis is an effective method for incorporating external environmental factors to create adaptive training systems that meet industry requirements and employee expectations.