Many researchers point to a significant reduction in the risk of oncological pathology in people suffering from allergic diseases. There is now an increased understanding of the key role of the microenvironment in tumor development. These include tumor-associated macrophages (TAMs), regulatory T-lymphocytes (Treg cells), and myeloid-derived suppressor cells (MCs). It is known that IgE appears in allergy and these antibodies are able to reformat protumor macrophages and Treg cells towards a proinflammatory state and tune them to an antitumor function.

In a woman's body, hormonal restructuring begins immediately after fertilization of the egg - a natural physiological process necessary for adequate gestation of the fetus. The first hormonal changes are caused by the activity of the ovarian corpus luteum, in which progesterone is synthesized. In parallel, the endocrine system of the fetus and the placenta begin to function. There is a functional relationship between the placenta and the fetus, which is a single endocrine fetoplacental system with some autonomy. The endocrine activity of the fetoplacental complex and ovaries determines the new functional level of all the endocrine glands necessary for the normal course of pregnancy. The interaction of two organisms - adult and embryonic - ensures the viability of both, the normal development of the fetus and the preservation of the health of the woman carrying the fetus. The activity of hormones is aimed at providing water-electrolyte, energy, metabolic, immune homeostasis.

Human capital is at the center of the sustainable development of society. Obstacles to sustainable development can be excessive growth or permanent decline in fertility. The main problem of the current demographic situation is the prevention of low birth rates, which will prevent the decline of the population and the aging of the entire population, its working age. One of the challenges facing public health today is to identify the main factors affecting childbearing - changing general social values, including the need to have children or the presence of barriers that prevent people from realizing their reproductive plans. Thus, research in the field of public health is aimed at improving the socio-economic situation in the country, investing in human capital, creating modern infrastructure in cities and villages, and providing an open mechanism for social development for all categories of citizens. Mother and child support programs around the world should be aimed at achieving an optimal demographic policy, the optimal intensity of the birth process, as well as various positive factors that affect them. The main aim of the study was to evaluate the current state of research on factors influencing birth in order to classify and identify new approaches and new knowledge. Research methods: research and analysis of scientific literature on research issues; comparison, analysis and generalization of normative documents and statistical data. The findings of the study are as follows: Despite efforts to create comparative aggregated data, most studies tend to focus on microdata, which do not allow for high comparisons. Thus, fertility research can be facilitated by collecting a collection of comparative micro-level fertility data from many countries, including the United States and Japan. Second, since researchers can only track the dynamics of fertility, the question of true causality remains more important than false relationships. The literature focuses on the problem of causality, but there is no doubt that the works of the economic tradition predominate. Causal interpretations are also common in association studies, but it is clear that some of them are not focused on understanding or studying causality.

Congenital epidermolysis bullosa (VBE) refers to orphan diseases. Face-to-face consultation is stressful for them, since moving in a car, in a wheelchair, dressing and undressing, removing bandages is very painful and difficult for the patient. There are not enough specialists with the appropriate level of competence in the settlements of Dagestan located far from the capital of the republic.
There is a threat of infection during a personal visit to a doctor in a pandemic of coronavirus infection. Teleconsultation removes all these problems.
The aim is to adapt telemedicine technologies to the remote format of verification of clinical diagnosis and dynamic observation of patients with VBE.
Materials and methods 93 patients with VBE were examined in a remote format. Both the doctor and the patient were consulted. Dynamic monitoring of some of them (eight people) was then carried out in a remote format using a mobile application for patients' smartphones.
Results and conclusion. With the help of telemedicine technologies, a detailed clinical diagnosis was verified in 98% of patients, and only one diagnosis was unspecified. Repeated online conversations were necessary in terms of clarifying the available information: concomitant diseases, clarifying the date of manifestation of the disease, the presence of sick relatives with a similar diagnosis. Face-to-face and remotely consulted patients (127 people) were included in the republican register of patients suffering from VBE. In most patients, multiple combined cases of organ and system complications were recorded - 614 cases in 127

The aim of the work was to develop distance learning modules for advanced training and training of primary health care and PTO doctors. The objectives of the study included the analysis of the distance learning system with an assessment of the need for this type of education. After the development of a scientific model of teaching on topical aspects of distance learning, its approbation and evaluation of its effectiveness were carried out. Several proposals have been developed to introduce new approaches and innovative technologies into the practice of a qualified specialist in distance learning. As a result of the work, the system of distance learning was analyzed, the need for distance learning was assessed, a scientific model of distance learning was developed, a scientific model of distance learning was tested, and recommendations for the introduction of innovative technologies were developed.

Cоngеnitаl hеаrt dеfеcts (CHD) rаnks а lеаding pоsitiоn in thе structurе оf infаnt mоrtаlity аnd rеmаin оnе оf thе mоst cоmmоn cаusеs оf pеrinаtаl mоrtаlity. CHD is а public hеаlth prоblеm nоt оnly in Kаzаkhstаn, but аll оvеr thе wоrld. This аrticlе prеsеnts thе rеsults оf а litеrаturе rеviеw оf sciеntific rеsеаrch pаpеrs оn thе prоblеm оf cоngеnitаl hеаrt dеfеcts publishеd in dоmеstic аnd fоrеign litеrаturе. А nеtwоrk sеаrch wаs cоnductеd in thе PubMеd, Gооglе Schоlаr аnd Mеdlinе dаtаbаsе fоr thе pеriоd 2017-2022.
Thе rеsults оf а rеtrоspеctivе аnаlysis оf 315 аrchivаl histоriеs оf nеwbоrns аnd birth histоriеs оf wоmеn whо gаvе birth tо childrеn with CHD fоr thе pеriоd frоm 01.01.2021 tо 31.12.2021 аrе аlsо prеsеntеd: risk fаctоrs fоr thе dеvеlоpmеnt оf CHD in thе fеtus, fеаturеs оf thе аnаmnеsis, prеnаtаl аnd pоstnаtаl diаgnоsis оf cоngеnitаl hеаrt dеfеcts, thе structurе оf CHD, trеаtmеnt mеthоds аnd thеir оutcоmеs аrе rеvеаlеd

This study was undertaken to examine the attitude of dentists towards immunization against COVID-19.
A sociological survey was carried out by questioning 101 doctors of dental institutions of various forms of ownership. The average age of the respondents was 42.8 ± 1.2, there were 26 men (25.7%), and 75 women (74.3%). The questionnaire consisted of 28 questions.
Only 42 (41.6%) dentists consider vaccines against COVID-19 effective, 26 (25.7%) of respondents consider it safe. As of July 30, 2021, 25 (24.8%) dentists were vaccinated. 44 (43.5%) were ill. In 18 (41.0%) people, PCR for SARS-CoV-2 is positive. In 21 (47.7%), it was confirmed by the results of the presence of IgG, IgM.
The main reasons for not vaccinating are the high rate of vaccine development without convincing clinical trials and unknown side effects. Cases of compulsory vaccination, work restrictions or coercion by the management in case of refusal to vaccinate are rare. It is believed that vaccination against COVID-19 should be mandatory for dentists, 37 doctors (36.6%). There is a consensus on the frequency of vaccination in medical no workers. 58 (57.4%) dentists recommend vaccination against COVID-19 to their patients at the reception, relatives and friends; 26 (25.7%) believe that it is available in their region. Given the choice of COVID-19 vaccine, the majority of dentists surveyed (69.1%) would choose Sputnik V (Gam-COVID-Vac).
Studying the opinion of doctors on immunization issues, as well as assessing their adherence to vaccination, allow us to timely identify existing problems and develop measures to eliminate them. It is necessary to increase the level of knowledge of doctors of dental institutions on the issues of vaccine prevention of COVID-19: the effectiveness and safety of vaccines, their availability in the region.

Introduction. With the onset of the pandemic, the composition of patients in the departments of anesthesiology and intensive care (OA&R) has changed, as well as the nature and volume of intensive care that can affect the microbial spectrum.
The aim of the study is a comparative analysis of the microbial spectrum and sensitivity of microorganisms to antibiotics in patients with OA&R in the dock and covid periods.
Methods. Two groups of patients of the OA&R of the Regional Infectious Diseases Clinical Hospital were examined in the dock (319 patients) and covid (179 patients) periods. 1237 bacteriological studies of biological material and determination of the sensitivity / resistance of the isolated strains to antibiotics were carried out.
Results. The duration of treatment in the covid period was 2 times longer than in the first period, in which 6 died, in the covid period - 52 patients. The number of bacteriological studies in the second period was 2 times more, despite the smaller number of patients. More often, pathogens were excreted from urine, nasopharynx, blood, in the 1st period from the cerebrospinal fluid, in the 2nd period - from sputum.
Among the pathogens in both periods, E. coli, Pr. mirabilis, St. aureus, Ps. aeruginosa, St. haemolyticus, Ent. fecalis, S. enteritidis, Sp. paucimobilis, St. hominis, Kl. pneumonia, Ac. baumani, Morganella spp., Citr. Freundi, only in the 2nd period - St. pneumonia, Streptococcus spp., Enterobacteriaceae and Enrerococcus groups, Ent. faecium, St. sciuri. The analysis of microflora in 52 patients who died from COVID-19 showed the predominance of the ESKAPE microbial spectrum: Ent.faecium and Ent. faecalis (7.9%), St. aureus (5.7%), Cl. pneumonia (25%), Ac. baumanii (5.7%), Ps. aeruginosa (3.8%), genus Enterobacter 7.9%). Significant differences in the resistance of the isolated flora to antibiotics and the formation of multiresistance to the covid period were noted.
Conclusions. The COVID-19 pandemic has changed the structure of the bacteriological spectrum in OA&R patients. The use of antibiotics led to an increase in the hospital strains presented by the ESKAPE group, an increase in resistance and multidrug resistance, which was one of the reasons for the decrease in the effectiveness of treatment. An additional reason for the growth of nosocomial strains is the congestion of OA&R with COVID-19 patients requiring respiratory support.

Сoronavirus infection (COVID-19) is a new, changing disease; several strains of COVID-19 mutated virus have already been reported. In children there have been described cases of acute disease with signs of Kawasaki disease and toxic shock syndrome, hyperreactive inflammation leading to multiple organ failure and shock [3; 4; 5]. This variant of the clinical course is referred to as multisystem inflammatory syndrome (MIS) in children and adolescents, temporarily associated with COVID-19. We analyzed the case histories of 14 children hospitalized at Children's Clinical Hospital №2 Almaty with the substantiation of a diagnosis of MIS temporarily associated with COVID-19. Clinical and laboratory features of this condition in children were determined. The average age was 5.5 years. By severity of condition, half of the children (50%) were admitted to intensive care unit. The examined children had symptoms corresponding to WHO criteria of MIS diagnosis - rash, abdominal syndrome (abdominal pain), diarrhea, vomiting. All patients had a significant increase in D-dimer from 430 to 6960 ng/ml.