Objective. The study seeks to examine how intensive exposure to digital technologies and excessive information flow affect learners’ cognitive functioning, particularly attention, memory, and processing efficiency, as well as to evaluate potential risks to academic performance in highly connected learning environments within the context of the educational transformation under the «Zhana Kazakhstan» program.

Materials and methods. An empirical survey was conducted among 54 adolescents (mainly 17-18 years old). Data were collected through an 18-item questionnaire covering patterns of digital device use, distraction frequency, study habits, and self-reported cognitive states (focus, memory, concentration, and fatigue). The results were analyzed using descriptive statistical techniques to identify general tendencies and relationships.

Results and discussion. The findings indicate intensive daily use of digital devices, with a significant proportion of respondents (48.1%) spending more than six hours online. Many participants reported regular interruptions during study sessions and a tendency to switch between tasks. More than half (57.4%) experienced reduced ability to maintain focus, while a notable share (33.4%) indicated difficulties retaining recently learned material. Signs of cognitive strain, including tiredness and perceived overload, were also widespread. These patterns suggest a transformation in cognitive functioning characterized by reduced depth of information processing and increased fragmentation of attention. Within the framework of the «Zhana Kazakhstan» program, this creates a tension between digital advancement and the preservation of stable cognitive functioning.

Conclusion. The results demonstrate that excessive digital exposure is associated with cognitive strain, including weakened concentration and memory efficiency. However, students’ awareness of these effects provides an opportunity to promote more conscious and regulated use of technology. Ensuring a balance between digital innovation and cognitive well-being remains a key challenge for modern education.

Sperm DNA fragmentation is an important functional marker of male fertility that complements conventional semen analysis and reflects damage to gamete genetic material.

This review aimed to summarize current evidence on biological, clinical, behavioral, and environmental factors associated with increased sperm DNA fragmentation. Professional guidelines, systematic reviews, meta-analyses, and key original studies indexed in PubMed, Scopus, and Web of Science were analyzed. Chromatin remodeling disorders, oxidative stress, apoptosis, impaired sperm maturation, and the effects of age, varicocele, inflammation, infections, metabolic disorders, cancer, fever, smoking, alcohol consumption, obesity, physical activity, sexual abstinence, heat exposure, and environmental pollutants were considered.

The most consistent associations were identified for varicocele, severe oxidative stress, smoking, advanced age, and certain toxic exposures. Laboratory and threshold heterogeneity limits direct comparisons. Clinical interpretation should consider the analytical method, patient history, and modifiable risk factors.

One of the surgical methods used to correct muscle spasticity in cerebral palsy (CP) is selective dorsal rhizotomy (SDR). The effectiveness of this method depends on the patient’s individual rehabilitation program (IRP), as well as on the timeliness, quality, and duration of rehabilitation interventions. This review presents a historical overview of SDR development, summarizes global experience in post-SDR rehabilitation for patients with CP, and highlights the key factors influencing its effectiveness. The success of SDR largely relies on a well-designed rehabilitation program that includes early initiation of physical therapy, optimal training intensity, and a multidisciplinary approach. The paper outlines the main stages of SDR evolution, analyzes current rehabilitation strategies, and provides examples of international protocols defining the frequency, duration, and sequence of therapeutic interventions. Special attention is given to postoperative kinesiotherapy, physiotherapy, neurodevelopmental techniques, and psychological support for families. The review emphasizes the need for standardization of rehabilitation programs and increased patient adherence to long-term therapy. The analysis confirms that combining surgical correction with comprehensive rehabilitation ensures optimal functional outcomes, promotes independence, improves quality of life, and strengthens the evidence base for developing national rehabilitation protocols.

The presented literature review contains data on histomorphological changes in the dermis when using isotretinoin. The systematic search was conducted for the results of scientific studies published between January 1980 and January 2026. The analysis included original researches, clinical and morphological work, experimental studies and review publications on morphological changes in the skin during systemic isotretinoin therapy. The result of the relevant search turned out to be 409 articles, of which, after the initial study, 25 articles were selected for final analysis: 19 articles were devoted to the anti-acne effect, the remaining 6 articles – to the involution of signs of photoaging against the background of the use of isotretinoin. Based on the literature analysis, data were collected on histological changes in the skin during the systemic use of isotretinoin from both the sebaceous glands and the dermis.

Systemic use of isotretinoin caused a number of changes in the skin, confirmed clinically and histologically. In particular, sebaceous glands were significantly reduced (up to 90%), and sebocyte differentiation was inhibited. The structure of the glands became elongated, «cellular» with a small number of sebocytes remaining in the center, on the basal plate. The amount of cytoplasm decreased by 35% compared to the size of the nucleus. There was a noticeable decrease in the number of immature cells and there was no mitotic numbers. The number of partially differentiated cells was very small, most of the cells were mature and full of lipid droplets. Desmosome destruction and disruption of links between keratinized keratinocytes were recorded, therefore, microcomedones regressed, and sebaceous filaments significantly decreased clinically. Follicular keratinization decreased by 55-70%. The amount of sebum and bacteria in comedones decreased markedly.

In the context of the effect of isotretinoin on photoaging, the following histological changes were identified: the significant increase in epidermal thickness, the decrease in elastosis, the decrease in epidermal p53, the straightening of the papillae of the dermis, the trophism improvement, the decrease in inflammatory infiltrate and in the degree of basophil degeneration of collagen, the increase in its density and concentration. There was the decrease in the number and changes in elastic fibers: elastic fibers were more tangled and fragmented before treatment, and more fibrillar and whole after treatment.

Aim. To evaluate the potential effects of energy drink consumption on the cardiovascular system among university students.

Materials and methods. The study voluntarily involved 200 students enrolled in higher educational institutions of Karaganda city. All participants were divided into two age groups: 18 – 22 years (group 1) and 23 – 27 years (group 2). Data were collected using a questionnaire survey. Statistical analysis was performed using Statistica v.10. Given the independent nature of the samples and the non-normal distribution of the data, the Mann – Whitney U test and Cramér’s V coefficient were used for group comparisons.

Results and discussion. A statistically significant association was found between the frequency of energy drink consumption and students’ age (χ²(3)=24.96; p<0.001). Cramér’s V coefficient was 0.39, indicating a moderate strength of association. Students aged 18 – 22 years consumed energy drinks more frequently than those aged 23 – 27 years. Among frequent consumers of energy drinks, 30% reported symptoms of palpitations, whereas among rare or non-consumers this figure was 10% (p<0.01). Tachycardia occurred 2.78 times more often in the younger age group. The odds ratio (OR=3.5) showed that the risk of developing tachycardia in students aged 18 – 22 years was 3.5 times higher compared with the older group. The differences were statistically significant (χ²=4.48; p<0.05).

Conclusions. The obtained data indicate that excessive and unregulated consumption of energy drinks has a negative effect on the cardiovascular system of students, especially those aged 18 – 22 years.

Aim. To develop, validate, and pilot-test a questionnaire for identifying risk factors for the development of chronic obstructive pulmonary disease (COPD) and associated conditions among healthy coal miners.

Materials and methods. The questionnaire consists of 5 sections (71 questions in total): sociodemographic and living conditions (16 questions), harmful habits (5 questions), health status and its changes during occupational activity (19 questions), nature of work and harmful occupational factors (19 questions), and assessment of the severity and intensity of the labor process (12 questions). Additionally, the following standardized instruments were attached: WHOQOL-BREF (quality of life), PHQ-9 (depression), Eysenck Personality Questionnaire (type of nervous system), Vaytenko aging index, and Münsterberg test (cognitive functions). Linguistic adaptation, expert review, and pilot testing were conducted on 102 healthy male coal miners (mean age 37.2±6.0 years). Construct validity was assessed using principal component analysis, and reliability was evaluated by Cronbach’s alpha coefficient. Statistical analysis was performed using IBM SPSS Statistics 13 and STATISTICA 10 software.

Results and discussion. The average time to complete the questionnaire was 7–8 minutes. The questions were understandable to the majority of respondents; only 5% required clarification of certain items. Factor loadings across the sections ranged from 0.639 to 0.871. Cronbach’s alpha values by section were as follows: 0.520 (socio-demographic and living conditions), 0.855 (harmful habits), 0.785 (health status), 0.757 (working conditions and occupational hazards), and 0.657 (severity and intensity of labor). These results indicate satisfactory construct validity and acceptable to good internal consistency for most sections.

Conclusions. The developed questionnaire demonstrates sufficient reliability and validity for use in scientific and epidemiological studies as well as in practical preventive work among coal miners. The obtained data enable the identification of groups at increased risk of developing COPD and the planning of targeted preventive measures.

Aim. To characterize the longitudinal relationships of baseline ACE2 and within-patient ACE2 change with complement components C3 and C4 and the hypoxia-related biomarker HIF-1α between 3 and 6 months after SARS-CoV-2 infection.

Materials and methods. This prospective longitudinal observational study included 69 patients with paired plasma samples collected at 3 and 6 months after COVID-19. Plasma concentrations of ACE2, C3, C4, and HIF-1α were quantified using enzyme-linked immunosorbent assays. Longitudinal changes were evaluated using paired analyses and random-intercept mixed-effects models. Secondary analyses included baseline-adjusted regression, change-score associations, Pearson and Spearman correlations, and ACE2 trajectory evaluation. Robustness was assessed using raw and log-transformed variables, influential-observation analyses, alternative trajectory thresholds, and exploratory nonlinear ACE2 models. False-discovery-rate correction was applied to prespecified hypothesis families.

Results and discussion. ACE2, C3, C4, and HIF-1α showed distinct longitudinal patterns between 3 and 6 months. Time-by-baseline-ACE2 interactions differed across the three biomarkers, with C4 showing the strongest ACE2-related signal, followed by C3 and HIF-1α. Although the linear interaction terms did not remain statistically significant after false-discovery-rate correction, complementary baseline-adjusted and change-score analyses indicated differentiated complement and hypoxia-related responses. Sensitivity analyses identified C4 as the leading candidate for a complex ACE2-associated longitudinal pattern, including evidence of nonlinearity, whereas HIF-1α showed pronounced temporal change with comparatively limited ACE2-centered association.

Conclusions. Complement and hypoxia-related biomarkers displayed distinct longitudinal behavior in relation to ACE2 during long COVID recovery. C4 showed the most prominent evidence of a potentially complex ACE2-associated pattern, while C3 and HIF-1α demonstrated different longitudinal profiles. These findings indicate that post-COVID biomarker evolution is pathway specific and cannot be fully represented by a single uniform linear ACE2-centered mechanism.

Aim. To evaluate the clinical, pathological and molecular factors associated with recurrence of papillary thyroid carcinoma in adolescents and young adults.

Materials and methods. The study design was a multicentre retrospective study. The study included 246 patients with papillary thyroid carcinoma, divided into two age groups: adolescents and young adults (aged 15 – 39 years) and patients over 39 years of age.

Results and discussion. Adolescents and young adults were found to have larger primary tumours, a

higher incidence of lymph node metastases (43.8% versus 23.4%; p=0.007) and a higher rate of recurrence (8.9% versus 2.0%; p=0.035). The BRAF V600E mutation was less common in adolescents and young adults (52.6% versus 76.1%; p=0.001). In the group of adolescents and young adults, recurrence was associated with lymph node metastases, a higher T stage, the TERT-p mutation, and the BRAF V600E/TERT-p combination.

Conclusions. The obtained results indicate that in adolescents and young adults, papillary thyroid carcinoma is characterized by a more aggressive locoregional course, which justifies the need for a comprehensive clinical and molecular assessment of the risk of relapse.

Introduction. Rheumatoid arthritis is a prevalent, disabling disease in which early diagnosis is crucial. The onset of the disease is generally associated with multiple risk factors; however, its etiology remains not fully understood. Currently, increased patient awareness and broad access to laboratory diagnostics for this condition enable timely detection and subsequent administration of appropriate treatment in accordance with clinical guidelines.

Aim. To evaluate patterns of rheumatoid arthritis manifestation based on clinical presentation in patients at an early stage of the disease, and to determine the  association between risk factors, the status of antibodies to cyclic citrullinated peptide, disease activity (Disease Activity Score 28).

Materials and methods. A cross-sectional study was conducted on 48 patients with early-stage rheumatoid arthritis between 2025 and 2026 to identify patterns in the manifestation of the disease.  Patients were surveyed, including identification of affected joint groups and associated risk factors. Disease activity was assessed using the DAS28, and patients were divided into groups with low, moderate, and high. Spearman’s correlation was used to determine the relationship between anti-CCP status and DAS28 scores.

Results and discussion. Disease activity was low in 10.42% of cases, moderate in 68.75%, and high in 20.83%. Patients with a positive anti-citrullinated peptide (anti-CCP) antibody test had lower DAS28 scores compared to those with a negative anti-CCP antibody test. Spearman’s correlation analysis demonstrated a statistically significant weak negative correlation between anti-CCP status and DAS28 scores (rs = –0.28; p = 0.048).

Conclusion. Thus, in this study of 48 patients, most individuals with early-stage rheumatoid arthritis exhibited moderate disease activity, which was associated with a high prevalence of anti-cyclic citrullinated peptide (anti-CCP) antibody positivity. Laboratory testing for the presence of antibodies to cyclic citrullinated peptides in patients with manifestation of articular syndrome may have potential clinical value in the  preclinical stages of rheumatoid arthritis.

Aim. To estimate the allele frequencies of single nucleotide polymorphisms (SNPs) associated with the risk of colorectal cancer (CRC) in the Kazakh population of Central Kazakhstan and compare the obtained results with international reference data.

Materials and methods. The study included 97 apparently healthy individuals with no diagnosed CRC or family history of malignant neoplasms, who self-identified themselves, their biological parents, and their maternal and paternal grandparents as Kazakh. Genotyping was performed using the TaqMan OpenArray platform. Following missingness control and assessment of genotype distributions for Hardy-Weinberg equilibrium, the data were harmonized with the 1000 Genomes Project Phase 3 reference dataset. The population position of the local group was assessed using principal component analysis and hierarchical clustering. For each SNP, absolute differences in allele frequencies between the local group and the Eurasian reference superpopulations were calculated, and the closest reference superpopulation was identified. Statistical outliers were excluded using Tukey’s fences. A total of 55 SNPs were included in the further analysis.

Results and discussion. Principal component analysis showed that the local group occupied an intermediate position within the Eurasian genetic space, predominantly between the European and East Asian superpopulations. In hierarchical clustering, the local group was represented in all four clusters, with most individuals distributed between two clusters of mixed population composition. The allele frequency profile of the analyzed SNPs showed pronounced locus-dependent variability. For 29 of the 55 SNPs (52,7%), the absolute allele frequency difference from the closest reference superpopulation did not exceed 0,025, whereas for 12 variants (21,8%) it was greater than 0,05. The closest reference superpopulation was EAS for 19 SNPs, EUR for 18 SNPs, and SAS for 18 SNPs.

Conclusions. The findings are consistent with the established understanding of the admixed genetic structure of the Kazakh population and demonstrate locus-dependent mosaicism in the allele frequency profile for the analyzed SNP panel. The nearly equal distribution of similarity across the Eurasian reference superpopulations indicates that no single reference superpopulation is the closest to the local group across the entire panel of variants. That should be taken into account while transferring findings from genome-wide association studies, applying polygenic risk scores, and planning medical genetic studies.

Aim. To evaluate the neuroprotective effects of Urtica dioica L. oil on oxidative stress and inflammatory responses in the brains of rats exposed to ionizing radiation alone or in combination with hexavalent chromium.

Materials and methods. Sixty-five white adult male rats were randomly assigned to five groups (n=13/ group): control, irradiation, irradiation + Urtica dioica L. oil, irradiation + Cr(VI), and irradiation + Cr(VI) + Urtica dioica L. oil. Seven days after irradiation, brain tissue was collected for biochemical analysis. Levels of malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were determined.

Results and discussion. Exposure to ionizing radiation, particularly in combination with Cr(VI), significantly impaired antioxidant defenses and increased lipid peroxidation and inflammatory cytokine levels in brain tissue. Pretreatment with Urtica dioica L. oil significantly increased SOD, CAT, and GSH levels while reducing MDA, TNF-α, and IL-6 compared with the corresponding untreated exposed groups (p<0.05).

Conclusions. Urtica dioica L. oil attenuated oxidative stress and neuroinflammation induced by ionizing radiation alone or combined with hexavalent chromium. These findings suggest that nettle oil has promising neuroprotective potential through enhancement of endogenous antioxidant defenses and suppression of inflammatory responses.

Nanoparticles (NPs) synthesized by the green synthesis approach have appeared as an environmentally friendly and sustainable strategy in the past decade. In this process, the bark extract of Terminalia arjuna (T. arjuna) functions as a reducing and capping agent for synthesizing silver nanoparticles (AgNPs). Different bioactive compounds, such as saponins, tannins, and flavonoids from bark extract, play an essential role in nanoparticle synthesis and stabilization. The appearance of a dark brown color in the solution visually confirms the nanoparticle formation. Furthermore, an absorbance peak at 410 nm wavelength confirms the biosynthesis of AgNPs. Moreover, process parameters (temperature, stirring time, and silver nitrate concentration) for nanoparticle synthesis were statistically optimized by using the response surface methodology (RSM) tool. The maximum synthesis of nanoparticles was achieved at 5 mM silver nitrate, 80° C temperature, and 40 minutes of stirring time. The spherical structure of AgNPs, with a size range of 10-120 nm and an average particle size of 36 nm, was discovered from transmission electron microscopy (TEM). Also, the X-ray diffraction (XRD) technique indicated the crystalline nature of synthesized AgNPs. Moreover, the antibacterial potential of silver nanoparticles was tested against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), which exhibit significant inhibition zones and advocate using AgNPs against antibiotic-resistant strains. This study reveals the capability of T. arjuna bark extracts in the biogenic synthesis of NPs with high antibacterial potential, which can be employed in different biomedical applications.

Aim. To develop the technology of a medicinal product in capsule form with mild diuretic activity based on dry extract of birch buds.

Materials and methods. During experimental research, a technology for obtaining dry extract from birch buds using 70% ethanol was developed. A material balance was calculated, and a technological and equipment flow chart was created. After optimizing the extraction conditions, the composition of a solid dosage form (capsule) was developed and prepared using a capsule-filling machine.

Results and discussion. Optimal extraction conditions were identified: raw material to extractant ratio – 1:1; solvent – 70% ethanol; temperature – 45-50 °C. The obtained dry extract was incorporated into the capsule formulation as follows: 0.300 g of dry birch bud extract, 0.195 g of potato starch, 0.003 g of Aerosil A-380, and 0.002 g of calcium stearate. All samples were studied in accordance with the requirements of the State Pharmacopoeia of the Republic of Kazakhstan.

Conclusions. A technology was developed for obtaining a dry extract from birch buds and a capsuleform medicinal product based on it, substantiated by the results of experimental research.

This study presents a comprehensive investigation aimed at improving the efficiency of the extraction process, as well as predicting and standardizing the quality of the obtained biologically active substances. For this purpose, the processing parameters of the medicinal plant Dasiphora parvifolia, which significantly influence the extraction process, were thoroughly examined. In particular, the true density, bulk and tapped density, packing weight, porosity, free volume of the extraction bed, and the extractant absorption coefficient were determined.

In addition, several pharmacopoeial quality parameters of the plant raw material were evaluated, including the content of extractive substances, loss on drying, total ash, and ash insoluble in 10% hydrochloric acid. These parameters are essential for assessing the quality of medicinal plant raw materials and their suitability for further pharmaceutical processing.

The experimental data obtained from the technological and pharmacopoeial characteristics make it possible to scientifically substantiate the selection of an optimal method for obtaining biologically active compounds and to standardize the quality of the resulting product in the form of an extract.

The results of this study can be applied in the development of production technologies for Dasiphora parvifolia plant extracts, as well as in the preparation of regulatory and technical documentation, including the technological regulations and quality specifications.

The article describes the possibility of obtaining P-vitamin flavonoids from Japanese sophora (Styphnolobium japonicum) flowers by extraction with acidified water at high temperature. In this system, water acts both as a reagent and as a solvent. The proposed approach eliminates the use of toxic organic compounds, combines the extraction and hydrolysis stages, and facilitates the final stage of purification. It has been established that the proposed method is more environmentally friendly than the known ones and allows several times to reduce the production time compared to the known traditional methods.

The innovative method of obtaining the antioxidant quercetin is based on high-temperature treatment of Japanese sophora flowers in an aqueous medium with the addition of mineral acids. This technological approach eliminates the need for expensive and toxic organic reagents. Combining the extraction and hydrolysis steps into one process optimizes the work cycle and simplifies the subsequent purification of the target products.

Aim. To develop and theoretically validate a combinatorial clonogenic assay design for optimizing the screening of plant extracts and to quantitatively evaluate its efficiency compared with the conventional approach.

Materials and methods. A theoretical model of a clonogenic assay was developed for a library of 10 plant extracts using two prostate cancer cell lines (DU145 and LNCaP) with three biological replicates. The conventional individual screening approach was compared with a hierarchical combinatorial design based on sequential pooling of extracts followed by deconvolution of positive pools. The required number of experimental stages, culture plates, and the overall efficiency of both approaches were calculated.

Results and discussion. The conventional approach required 60 culture plates to evaluate 10 plant extracts, whereas the proposed hierarchical combinatorial design reduced this number to 36 plates, corresponding to a 40% reduction in experimental workload. The efficiency of the proposed method increased with library size, reaching an 86% reduction in the number of experimental units when screening 100 samples. The proposed strategy decreases reagent consumption, shortens experimental time, and increases screening efficiency while maintaining the number of replicates and statistical reliability. The method is particularly effective for identifying the most active extract but requires subsequent validation when multiple active compounds or synergistic interactions are expected.

Conclusions. The hierarchical combinatorial design is an effective approach for optimizing clonogenic assays by substantially reducing the number of experimental procedures, time, and material costs while preserving the reliability of the obtained results. This strategy can be applied as a primary high-throughput screening tool for plant extracts and other biologically active compounds before detailed validation studies.

Aim. To analyse working conditions, labour relations, and the system of professional development of nursing personnel in Kazakhstan in the context of the requirements of International Labour Organization (ILO) Convention No. 149 and ILO Recommendation No. 157. The study examines international approaches, the regulatory and legal framework, and the results of a sociological survey of nurses, which make it possible to identify key challenges and directions for their resolution.

Materials and methods. The study employed a mixed-methods approach, combining quantitative, qualitative, and comparative-analytical methods to assess working conditions, labour relations, and the system of professional development of nursing personnel in the Republic of Kazakhstan.

Results and discussion. International practice demonstrates that effective management of healthcare systems is not possible without taking into account the condition of human resources and the working conditions of healthcare workers. In EU and OECD countries, monitoring systems are used to assess workforce availability, workload, and the impact of working conditions on the quality of healthcare services. Similar approaches are applied by the WHO and ILO in assessing the sustainability of healthcare systems.

Conclusion. The study results demonstrate that ensuring the sustainability of the healthcare system in the Republic of Kazakhstan requires a transition from a purely quantitative approach to workforce management to a comprehensive model that takes into account working conditions, occupational risks, and human resource development. The implementation of the proposed measures will reduce the workload on healthcare workers, improve their quality of working life, and ensure the effective functioning of the healthcare system in the long term.

In modern urological practice, anomalies of the urinary system development, such as ureterocele, often become an etiological factor for severe forms of urolithiasis. This clinical case of a 42-year-old female patient with bilateral ureterocele complicated by a large ureteral stone amidst obstructive uropathy demonstrates the capabilities of modern minimally invasive surgery in treating rare congenital pathologies in adults. In 2025, at the urological department of the SME on REM «Municipal multidisciplinary Hospital No. 2» (Astana c., Republic of Kazakhstan), a simultaneous endoscopic operation was successfully performed: bilateral laser ureterocele incision combined with contact laser lithotripsy.

The diagnostic algorithm, based on multispiral computed tomography, allowed for a detailed verification of the anatomical features of the malformation and the density of the calculus. Despite the complexity of the simultaneous intervention, the operation was characterized by minimal invasiveness and an absence of intraoperative complications. A positive clinical trend was observed in the postoperative period: complete stone destruction was achieved, adequate urodynamics were restored, and renal function was stabilized (glomerular filtration rate 86-89 mL/min/1.73 m²). The patient was discharged in satisfactory condition, confirming the high efficiency of the chosen strategy.

Analysis of this case within the context of current literature shows that simultaneous laser interventions significantly reduce the duration of inpatient treatment, minimize the anesthetic burden, and avoid staged surgeries. This approach not only reduces the risk of iatrogenic complications but also facilitates the rapid socio-occupational rehabilitation of patients. The presented clinical case emphasizes that transurethral laser ureterotomy is a safe, cost-effective, and gold standard treatment for ureterocele, providing reliable prevention of recurrent obstruction and preservation of the renal reserve.

Nephroblastoma is the most common high-grade embryonic tumor of the genitourinary tract in children. Considering the violation of the processes of nephrogenesis, it should be assumed that congenital renal dysembriogenesis is important among the pathogenetic mechanisms of nephroblastoma formation. The trigger of the tumor process can be elements of foci of dysplastic structures in the form of primitive tubular structures and metanephrogenic tissue in children at risk born to mothers with a complicated pregnancy and the presence of somatic kidney pathology.

The article presents a case of morphological verification of a clinical diagnosis in an 8-year-old patient. This clinical case demonstrates that when making a clinical diagnosis, it is necessary to carefully collect the medical history of the disease, find out the gestation period and features of the course of pregnancy, the presence of risk factors that could affect the features of the intrauterine development of the fetus and newborn, and the histogenesis of the kidneys. Taking into account the comprehensive approach to the differential diagnosis of the pathological process, it is necessary to evaluate the results of modern methods of radiation diagnostics and additional research methods.

The described clinical case proves once again that a multidisciplinary, integrated approach should be applied when making a clinical diagnosis. In the morphological verification of the clinical diagnosis, it is of great diagnostic importance to conduct an immunohistochemical study to determine the phenotype and proliferative activity of the tumor.

Breast cancer (BC) occupies a leading position among all oncological diseases. More than 2.3 million new cases are registered annually, and the death rate exceeds 670 thousand. In the Republic of Kazakhstan, the incidence is steadily increasing (in 2024, the primary incidence was 204.8 per 100,000 population), while 94.3% of cases are detected at stages I – II, and 82% of cases are women of active working age (up to 65 years), which emphasizes the socio-economic importance of maintaining the quality of life.

Radical mastectomy remains the standard of surgical treatment, ensuring oncological radicalism. However, the loss of the breast (the organ that defines female identity) leads to psychoemotional disorders and social stigmatization. Simultaneous implant reconstruction allows combining radicalism and aesthetics, improving the psychological state of patients and reducing disability. The key success factor is the choice of a fixing material to strengthen the lower pole of the implant. This is what determines the frequency and severity of complications (seroma, infection, necrosis of the skin flap, capsular contracture, implant loss), reaching 2035%. Traditional axillary lymphodissection (TAL) in the surgical treatment of breast cancer is associated with a high risk of lymphedema (20-40%), which significantly affects the quality of life.

The article describes a clinical case of a 34-year-old patient with luminal B, HER2/neu-negative subtype of BC, who received neoadjuvant chemotherapy. During surgical treatment, a radical mastectomy with simultaneous reconstruction with an implant and mesh was performed, as well as preventive lymphatic reconstruction during TAL. The postoperative period was uneventful; the signs of lymphedema were observed dynamically (6 months) and were not revealed. The case demonstrates the integration of modern approaches: the patient underwent surgery (subcutaneous radical mastectomy with simultaneous reconstruction of the implant, fixation of the lower pole of the implant with a polypropylene mesh, biopsy of the signal lymph node and intraoperative staging (N-status) using ICG lymphography), then, according to the indications, an extended lymph dissection of 1-3 orders was performed, simultaneous application of lymphvenular anastomosis for the prevention of lymphedema.

The described comprehensive approach in the treatment of patients with breast cancer is important for the Republic of Kazakhstan, where there is an increase in the number of young patients with breast cancer and access to reconstructive and microsurgical technologies is limited.