Relevance. Obstructive Sleep Apnea is one of the most common sleep-related breathing disorders and is considered an important risk factor for cardiovascular and metabolic diseases.

Objective. To assess the detection rate of obstructive sleep apnea syndrome based on the analysis of clinical data of hospitalized patients, polysomnographic findings, and a survey of primary health care physicians.

Materials and methods. A retrospective descriptive analysis of official statistical data on the registration of obstructive sleep apnea syndrome in the Osh region of the Kyrgyz Republic and Osh city was conducted, along with a review of medical records of 152 patients diagnosed with obstructive sleep apnea syndrome who were hospitalized in the pulmonology department of the Osh Interregional Clinical Hospital during 2020–2024. Polysomnography results from 71 patients, obtained in private medical centers, were analyzed. Additionally, a survey of 78 primary care physicians was conducted to assess awareness and diagnostic practices regarding obstructive sleep apnea syndrome.

Results. The analysis showed that the official registration of obstructive sleep apnea syndrome in the region remains low, indicating underdiagnosis. The study population was predominantly older adults (63.2 ± 12.7 years) with elevated body mass index (median 35 [32–38] kg/m²). A high prevalence of comorbidities was observed, including Chronic Obstructive Pulmonary Disease (90.8 %), Obesity (90.1 %), Hypertension (75.0 %), and Coronary Heart Disease (69.1 %). According to polysomnography, the median apnea-hypopnea index was 18 (10-35.5) events/hour, and the median desaturation index was 32.0 (14.3–46.6) events/hour; most patients had moderate to severe disease. Survey results showed that 63 % of physicians do not use Epworth and STOP-BANG screening questionnaires, and 82 % do not refer patients for polysomnography.

Conclusions. The low detection rate of obstructive sleep apnea syndrome in the region is associated with clinical characteristics of the disease and insufficient use of screening tools and specialized diagnostic methods.

Relevance. Declining fertility and population aging remain key demographic challenges affecting the sustainability of healthcare systems and long-term socio-economic development.

Objective. To analyze demographic dynamics in the Republic of Kazakhstan and the city of Almaty for 2000-2024 and to forecast births, deaths, and natural population increase for 2025-2030 using time-series analysis methods.

Materials and Methods. Official statistical data from the Bureau of National Statistics of the Republic of Kazakhstan on births, deaths, and natural population increase were analyzed. Absolute and relative growth rates, as well as growth coefficients, were calculated, and time-series dynamics were assessed. Forecasting was performed using the Brown double-exponential smoothing model for births and ARIMA models for deaths, with a projection horizon of 2025–2030. Model quality was evaluated using the coefficient of determination (R²) and residual diagnostics (Ljung–Box test).

Results. In Kazakhstan, from 2020 to 2024, the number of births declined by 14.25 % (from 426,726 to 365,923), the number of deaths decreased by 17.42 % (from 160,962 to 132,916), resulting in a 12.33 % reduction in natural population increase (from 265,764 to 233,007). In Almaty, the number of births decreased by 3.34 % and the number of deaths by 15.55 %, while the natural population increase rose by 4.98 % to 22,196, reflecting a relatively more stable demographic situation.

Forecast estimates indicate a further decline in the number of births in Kazakhstan – from 347.1 thousand in 2025 to 249.5 thousand by 2030 – with relatively stable mortality, leading to a reduction in natural increase to 105.0 thousand. In Almaty, moderate growth in births (from 35.2 to 39.2 thousand) alongside stable deaths is expected to increase the natural population growth to 26.9 thousand.

Conclusions. Divergent demographic trajectories were identified: increasing demographic pressure at the national level and relative stability in the metropolis. Forecast estimates should be interpreted cautiously, given the inertial nature of time-series models and the lack of external demographic and socio-economic determinants in the projections.

Relevance. Hearing loss is one of the leading causes of reduced quality of life and disability among adults. In post-Soviet countries, including Kazakhstan, hearing disability is primarily determined by medical criteria, which may lead to an underestimation of the social and psychological consequences of even mild or moderate hearing loss.

Objective. To assess the quality of life of adults with hearing loss in the Republic of Kazakhstan using hearing-specific instruments – the Hearing Handicap Inventory for the Elderly and the Hearing Handicap Inventory for Adults – and to analyze the relationship between audiometric hearing loss severity and subjectively perceived hearing-related limitations.

Materials and Methods. A cross-sectional study was conducted involving 48 respondents aged ≥18 years with audiometrically confirmed hearing loss. QoL was assessed using the Hearing Handicap Inventory for Adults and the Elderly. Descriptive statistics and correlation analysis were applied.

Results. The mean total Hearing Handicap Inventory for Adults and the Elderly score of 62.4 ± 15.3 indicated a severe perceived functional limitation. More than 65 % of participants demonstrated a marked reduction in QoL (≥43 points), including individuals with mild and moderate hearing loss. A statistically significant correlation was found between hearing loss severity and the total Hearing Handicap Inventory for Adults and the Elderly score (ρ = 0.74; p < 0.001), as well as between age and the degree of hearing handicap (ρ = 0.49; p < 0.001).

Conclusion. Hearing loss has a significant negative impact on the QoL of adults in Kazakhstan, regardless of official disability status. The use of hearing-specific questionnaires allows identification of the hidden burden of the condition and should be integrated into clinical and medico-social practice.

Relevance. The transition toward risk-oriented occupational safety systems requires modernizing social protection mechanisms for employees exposed to hazardous working conditions. In Kazakhstan, social guarantees are traditionally based on occupational classifications that do not fully reflect actual workplace risk exposure or economic sector characteristics.

Objective. To develop and validate an integrated methodological approach for ranking occupations based on professional risk levels and economic activity characteristics.

Materials and Methods. This study, conducted in 2024-2025, included an analysis of occupational risk assessment data from pilot enterprises, an evaluation of national labor statistics, and findings from a sociological survey of 312 respondents. An integrated ranking index was developed by calculating a sectoral coefficient reflecting economic activity characteristics. Statistical analysis was performed using SPSS 27.0.

Results. Significant variability in occupational risk levels across economic sectors was identified. High and critical risk levels were predominantly observed in mining, metallurgical, and chemical industries, while lower risk levels were characteristic of service and administrative sectors. The proposed integrated ranking model demonstrated the ability to differentiate occupations with similar professional risk exposure by incorporating sector-specific economic indicators, thereby enabling a more precise distribution of social guarantees.

Conclusions. The developed model establishes a scientifically justified relationship between occupational risk level and allocation of social guarantees. Implementing the proposed methodology may enhance the effectiveness of occupational safety regulation and support the transition toward a preventive, risk-oriented social protection system in Kazakhstan.

Relevance. Hemorrhoids are among the most common anorectal diseases and remain an important clinical and organizational challenge in modern coloproctology. However, long-term trends in surgical treatment at the city level have received insufficient attention.

Materials and Methods. A retrospective, descriptive, and analytical study of surgical interventions for hemorrhoids performed in medical organizations in Almaty from 2012 to 2021 was conducted. The analysis was based on official aggregated statistical data provided by the Republican Center for Healthcare Development of the Republic of Kazakhstan. The total number of operations, elective and emergency procedures, and the proportion of elective interventions were assessed. Descriptive statistics, linear regression, and time-series forecasting were performed using IBM SPSS Statistics 26.0.

Results. From 2012 to 2021, the total number of operations ranged from 43 to 619 per year, with a mean of 269.9±191.4. The mean annual number of elective operations was 109.5±100.9, while emergency procedures averaged 160.4±136.7. A statistically significant upward trend was identified for the total number of operations (β = 46.418, 95 % CI: 11.446-81.391, p = 0.016, R² = 0.539) and for elective procedures (β = 28.103, 95 % CI: 13.504-42.702, p = 0.002, R² = 0.711). No significant trend was found for emergency operations (p = 0.245). The proportion of elective procedures showed an upward trend, although it did not reach statistical significance (p = 0.058). Forecast estimates suggested a possible further increase in the total and elective numbers of operations, but these results should be interpreted cautiously due to wide confidence intervals.

Conclusion. In medical organizations in Almaty, surgical treatment for hemorrhoids generally increased from 2012 to 2021, mainly due to the growth of elective procedures. These findings may be useful for assessing the burden on surgical services and for planning proctologic care.

Relevance. The COVID-19 pandemic placed unprecedented pressure on hospital systems, exposing structural vulnerabilities in resources, governance, and workforce capacity. In Kazakhstan, particularly in Almaty, major system reorganizations, including modular COVID-19 hospitals, were implemented; however, qualitative data on healthcare managers’ views on their effectiveness and preparedness for future challenges remain limited.

Objective: This study aims to explore healthcare managers’ experiences of hospital functioning during the COVID-19 pandemic in Almaty, assess the perceived effectiveness of implemented measures, and identify key factors influencing preparedness and resilience for future pandemics.

Materials and Methods.  A qualitative study design was employed using semi-structured in-depth interviews. Sixteen healthcare managers (5 senior-level and 11 mid-level) from multidisciplinary hospitals in Almaty were recruited through purposive sampling via professional WhatsApp groups. Data were collected in the first quarter of 2026 through online interviews lasting 15-20 minutes. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis.

Results. Seven interrelated topics were identified: (1) hospital overload as a manifestation of systemic unpreparedness; (2) resource constraints, with oxygen infrastructure as a critical bottleneck; (3) modular COVID-19 hospitals as a key adaptive strategy; (4) the importance of timely and coordinated organizational responses; (5) workforce well-being as a core determinant of system performance; (6) partial preparedness for future pandemics; and (7) the need for an integrated and adaptive preparedness system. Modular hospitals were perceived as a turning point in the pandemic response, improving capacity and system coordination. Despite improvements, persistent challenges related to workforce shortages, governance, and digital infrastructure remain.

Conclusion. Hospital system performance during the COVID-19 pandemic was shaped by the interaction of resources, governance, and workforce resilience. The findings highlight the need for integrated and adaptive health system approaches, including scalable infrastructure, strengthened workforce policies, improved governance, and enhanced digital systems, to ensure preparedness for future public health emergencies.

Introduction. Proximal humerus fractures are among the most common injuries of the musculoskeletal system. Conventional osteosynthesis techniques used in the surgical treatment of these fractures do not always provide sufficient mechanical stability, which highlights the need for the development of new biomechanically justified fixation devices.

Objective. To perform a comparative assessment of the stress–strain state of the biomechanical systems «HUMERUS – LOCKING PLATE» and «HUMERUS – NEW DEVICE» using the finite element method.

Materials and Methods. The study was conducted as a biomechanical simulation using KOMPAS-3D (APM FEM) and Autodesk Inventor Professional software. Two biomechanical systems were analyzed in the finite element model: «HUMERUS – LOCKING PLATE» and «HUMERUS – NEW DEVICE». The following loads were applied in the models: axial load F1 = 200 N, transverse load F2 = 100 N, and torsional moment M = 7.5 N · m. The loads were applied both separately and simultaneously. The evaluation criteria included equivalent von Mises stress, maximum linear displacement of system elements, and the minimum safety factor.

Results. Under all loading conditions, the «HUMERUS – NEW DEVICE» system demonstrated more favorable biomechanical characteristics compared to the locking plate. In particular, the new device showed lower equivalent stress values, reduced linear displacement, and a higher safety factor. The most pronounced differences were observed under tensile and torsional loading conditions.

Conclusion. The results of the finite element analysis indicate that the proposed device provides greater biomechanical stability than the locking plate in the osteosynthesis of proximal humerus fractures. The obtained findings demonstrate the potential advantages of the new design; however, further experimental and clinical studies are required to fully evaluate its effectiveness.

Relevance. Adenoid hypertrophy is a leading cause of chronic nasal obstruction in children and significantly affects quality of life.

Objective. To evaluate the efficacy and safety of selective endoscopic laser adenoidectomy compared with conventional curettage adenoidectomy.

Materials and Methods. A single-center comparative study (Almaty, Kazakhstan) included 58 patients: 46 underwent laser adenoidectomy and 12 curettage adenoidectomy. Recurrence rates, subjective symptoms, rhinomanometry and tympanometry results, and late complications were assessed at 3 and 6 months.

Results. Recurrence rates were significantly lower after laser adenoidectomy (2.2% and 4.3%) compared to curettage (50.0% and 41.7%) at 3 and 6 months, respectively (p < 0.01). Subjective symptoms and functional impairments were less frequent in the laser group. No significant differences in complication rates were observed.

Conclusions. Endoscopic laser adenoidectomy is a more effective and safe alternative to conventional curettage adenoidectomy in children with chronic nasal obstruction.

Relevance. Trochanteric femoral fractures are common in elderly patients and are mainly treated using intramedullary fixation devices. Despite this method's effectiveness, rare but potentially life-threatening complications may occur.

Case report. We present a clinical case of an extremely rare complication, medial migration of a Gamma nail lag screw into the pelvic cavity with perforation of the urinary bladder. The patient presented with lower abdominal pain and urinary symptoms several months after osteosynthesis. Radiological and tomographic examinations revealed migration of the screw into the urinary bladder. Surgical removal of the implant with subsequent bladder repair was performed.

Conclusion. This clinical case demonstrates the potential for severe complications even after technically satisfactory primary osteosynthesis and highlights the importance of careful postoperative monitoring and a multidisciplinary approach to treatment.

Relevance. This article presents an analytical review of current approaches aimed at improving the efficacy and safety of nonsteroidal anti-inflammatory drugs, which are widely used in clinical practice for inflammatory and pain syndromes. Despite their high therapeutic efficacy, nonsteroidal anti-inflammatory drugs are associated with adverse drug reactions, including gastro- and hepatotoxicity, which significantly limit their long-term use. In this context, particular attention is paid to glycyrrhizic acid as a natural anti-inflammatory and cytoprotective agent with antioxidant and membrane-stabilizing properties. Experimental evidence demonstrating the potential of combining nonsteroidal anti-inflammatory drugs with glycyrrhizic acid to reduce toxicity and enhance anti-inflammatory effects is presented.

Objective. To systematize current literature data on modern approaches to reducing adverse effects of nonsteroidal anti-inflammatory drugs and to evaluate the potential of glycyrrhizic acid as a natural adaptogen for improving therapy safety.

Materials and Methods. A literature analysis was conducted based on publications indexed in PubMed Central, Scopus, Web of Science, Google Scholar, as well as national scientific electronic libraries, covering the period from 2000 to 2025. Earlier studies were also included due to the relevance of key research on combinations of glycyrrhizic acid with synthetic drugs conducted prior to 2010. Inclusion criteria comprised experimental and clinical studies, as well as review articles addressing the pharmacological properties of nonsteroidal anti-inflammatory drugs, mechanisms of their adverse effects, and the biological activity of glycyrrhizic acid and its potential for combined use.

Results. The analysis of the literature demonstrated that improving the safety profile of NSAIDs remains an important issue in modern pharmacotherapy. Glycyrrhizic acid, as a natural compound with pronounced anti-inflammatory, antioxidant, and cytoprotective properties, is considered a promising agent for the pharmacological correction of nonsteroidal anti-inflammatory drug-induced adverse effects.

Conclusions. The combination of nonsteroidal anti-inflammatory drugs with glycyrrhizic acid represents a promising approach for developing safer and more effective anti-inflammatory therapies.

Relevance. With the increasing number of major joint arthroplasties, aging population, and limited access to medical care, including during the pandemic, telerehabilitation has gained particular relevance in recent years.

Materials and methods. A literature search was conducted in the databases PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar to identify publications on telehabilitation after total knee replacement. The original research and literature reviews published over the past 15 years were mainly selected. The analysis included full-text articles on telerehabilitation after total knee replacement.

Results. The data indicate the promising potential of implementing digital solutions through telerehabilitation within the rehabilitation medicine system and the advisability of using it as a complement to traditional rehabilitation methods. Telerehabilitation increases access to specialized care and enhances continuity of patient follow-up. Systematic literature review indicates that telerehabilitation can be a practical alternative to in-person rehabilitation therapy for patients who have undergone total knee arthroplasty. Telerehabilitation programs reduce direct postoperative rehabilitation costs by an average of 10-40 % per patient compared to traditional in-person rehabilitation, due to lower transportation costs, fewer clinic visits, and more efficient use of human resources.

Conclusion. Telerehabilitation should be regarded as a promising tool ensuring continuity of rehabilitation for patients after total knee arthroplasty. In digital healthcare, telerehabilitation helps optimize resource use and ensures patients in remote areas have access to rehabilitation services.

Relevance. The growth of mass and professional sports increases the participants’ workloads and the risk of injury, underscoring the need for effective medical support systems. Modern sports medicine has developed as an interdisciplinary field, combining prevention, diagnosis, treatment, and rehabilitation for athletes of all levels.

Objective. To analyze modern approaches to organizing sports medicine services and medical support for athletes.

Materials and Methods. The literature review covered publications from 2006 to 2026 in PubMed, Scopus, Web of Science, and professional reports, focusing on the organization of sports medicine services, medical support for athletes, and injury prevention. Articles in Russian and English with full text, dedicated to medical support in mass and professional sports, were included; studies without full text and research limited only to physiology or the training process were excluded.

Results. The review showed that medical support in mass sports is focused on injury prevention, the organization first aid, and safe conduct of events, while high-performance sports require individualized, comprehensive and interdisciplinary support for athletes. Modern systems include centralized management, digital technologies, and integration of various specialists, improving the effectiveness of injury prevention, rehabilitation, and athlete preparation.

Conclusions. The development of sports medicine services requires an interdisciplinary approach, standardization of specialist training, and the introduction of digital technologies. These measures ensure the safe participation of athletes at all levels, reduce recovery time, and enhance the effectiveness of training and competition.

Relevance. Somatized mental disorders and persistent physical symptoms are an important but often insufficiently recognized problem in primary health care. Such patients usually turn to primary health care doctors first; however, the variety of symptoms, accompanied by anxiety and depression, stigma, and diagnostic difficulties, hinders their timely detection. In this regard, it is important to integrate mental health into the primary health care system and develop interdisciplinary care models.

Objective. To systematize current evidence on the evolution of terminology, the causes of underrecognition, the tools for early identification, and the organizational models of mental health integration relevant to the diagnosis of somatized mental disorders at the primary health care level.

Materials and Methods. This study was conducted as a narrative review, with a systematic literature search across PubMed, Scopus, and Web of Science, and an analysis of documents issued by the World Health Organization, World Health Organization /Europe, and the World Organization of Family Doctors. The main focus was placed on publications from 2015 to 2025; however, earlier works of conceptual importance were also included. The initial search identified 107 publications, of which 43 sources were included in the final analysis after title and abstract screening and duplicate removal.

Conclusions. Current scientific data show that the transition from the concepts of somatoform disorders and medically unexplained symptoms to the concepts of Somatic Symptom Disorder, bodily distress disorder, and persistent physical symptoms is important for clinical practice in primary health care. The diagnosis of these conditions should be based on periodic clinical assessment, including screening tools (PHQ-15, SSS-8, SSD-12), dynamic monitoring, and functional status assessment. The integration of mental health into primary health care and the development of a multidisciplinary approach will contribute to early detection and improved access to health care.

Relevance. Oral health is closely linked to overall health status. Children with cerebral palsy have an increased risk of dental diseases due to motor, cognitive, and behavioral characteristics, which negatively affect their quality of life. Despite the importance of timely dental care, its accessibility is often limited by clinical, organizational, and educational factors.

The aim. To analyze factors influencing the accessibility and organization of dental care for children with cerebral palsy, with an assessment of the role of professional training of specialists and organizational-system conditions as key determinants of the quality of dental care.

Materials and Methods. An analytical review of scientific publications, clinical guidelines, and regulatory documents was conducted. The literature was searched in PubMed, Scopus, Web of Science, and Google Scholar. The analysis was performed using a descriptive synthesis with thematic systematization of factors affecting dental care accessibility.

Results. A combination of individual professional readiness of specialists and organizational-system conditions determines the accessibility of dental care for children with cerebral palsy. Insufficient knowledge and clinical experience of dentists, limited infrastructure, inadequate equipment of healthcare facilities, weak implementation of interdisciplinary approaches, and organizational barriers reduce actual access to care even when financial coverage is available. Adaptation of dental appointments, development of interdisciplinary teamwork, and expansion of educational programs are particularly important.

Conclusion. Ensuring accessible, high-quality dental care for children with cerebral palsy requires a comprehensive approach that includes improving specialist training, fostering interdisciplinary collaboration, enhancing infrastructure, and establishing clear standards of care. Even with affordable prices, access to dental care may be limited by staffing, organizational, and resource-related factors.

Relevance: Psoriasis is a chronic inflammatory disease characterized by its polygenic nature and the leading role of immune mechanisms. It is based on skin and joint damage. Clinically, the disease is characterized by erythematous rashes covered with silver scales. Despite significant progress in elucidating the pathogenesis and the introduction of targeted biological drugs, it has not yet been possible to achieve sustainable, long-term disease control. In this regard, there is a pressing need to develop new therapeutic strategies targeting key links in the pathogenesis. The use of antisense oligonucleotides is considered a promising therapeutic approach.

Objective: To analyze modern concepts of the immunopathogenesis of psoriasis and evaluate the therapeutic potential of antisense oligonucleotides.

Materials and Methods: A literature search was conducted in the PubMed, Scopus, Web of Science, Google Scholar, ScienceDirect, and the Cochrane Library databases. Articles published from 2010 to September 2025 were selected for inclusion. Inclusion criteria comprised articles published in peer-reviewed journals focusing on the immune pathogenesis of psoriasis, the IL-23/IL-17 and IL-36 signaling axes, and the therapeutic potential of antisense oligonucleotides. Only publications with full-text availability and direct relevance to the research topic were considered for inclusion. Exclusion criteria included articles not directly relevant to the research topic, duplicate publications, conference abstracts, letters to the editor, and studies without full-text availability.

Results: Analysis of recent articles in international scientific databases highlights the importance of the IL-23/IL-17 and IL-36 axes in the development of psoriasis. These signaling pathways support chronic inflammation and promote the pathological proliferation of keratinocytes. Moreover, the obtained data indicate that antisense oligonucleotides may represent a promising approach for pathogenetic therapy and can expand the possibilities for targeted treatment of psoriasis.

Conclusions: Psoriasis is a chronic immune-inflammatory disease. In its pathogenesis, the IL-23/IL-17 and IL-36 axes play a key role in the regulation of keratinocyte proliferation, leading to sustained inflammatory mechanisms. Antisense oligonucleotides used in its treatment selectively act on key pathogenic links by suppressing the expression of genes responsible for disease initiation. Although the aforementioned method represents one of the promising approaches for targeted intervention at the molecular level in the disease, there is a need for further in-depth investigation of its efficacy and safety before clinical implementation.