The review article describes the main problems of antibiotic resistance in the treatment of patients with UTI and presents studies of the last decades in this area. At present, it is recommended to consider antibiotic groups with intact microbiological activity against E. Coli: nitrofurans, fosfomycin, fluoroquinolones as drugs of empirical choice for urinary tract infections.

Vitamin D is essential for many physiological processes and maintaining optimal health. Vitamin D deficiency, as determined by 25(OH)D levels of less than 30 ng/ml and less than 20 ng/ml, is widespread throughout the world. Active searches are underway to confirm the association of vitamin D with kidney disease. The literature review provides data on the role of vitamin D in the body, and taking into account current data, the relationship between the level of vitamin D and the progression of chronic kidney disease in children is considered.

Primary health care is the first and main link between society and the health system. It is the first level of contact and the stage of the continuous process of protecting public health. This literature review presents the main results of evaluation tools for analysis of activities of primary health care services. The authors conducted a systematic search for scientific publications in the search engines PubMed, Web of Science, Google Scholar, in the CyberLeninka electronic scientific library. Search depth was 15 years old. 532 sources were found, of which 47 were selected after the initial analysis. For the final analysis, 8 articles were selected. A comparative analysis of primary care performance activity assessment tools showed the effectiveness of valid tools such as the Primary Care Assessment Tool (PCAT) and the service availability and readiness assessment (SARA).

An analysis of randomized trials, and current views on the problem of the prevalence and incidence of sarcoidosis are presented in the review. The epidemiology of sarcoidosis and its clinical manifestations significantly vary depending on geographical regions, various ethnic and age groups, gender. The impact of social status, occupational factors, smoking, seasonal variations was analyzed. The connection between the development of the disease with obesity and gaining of weight, as well as influence by infectious agents was studied. The data of genomic studies and history of sarcoidosis in the family were assessed.

The article presents the results of research conducted by students who study hemodynamics and physical activity. The activity of this study is associated with insufficient knowledge and a high frequency of lesions of the circulatory system in the brain. 37 medical students of the 2^nd and 3^rd course specialties «General medicine», which use modern computerized rheograms of the Mitsar-Reo company (St. Petersburg) with software that performs an automatic analysis of rheoencephalogram. The method of rheography, as is known, is based on Ohm's law. Adaptive brain vascular responses to a hypotonic type with gender differences were revealed: age, rheographic index, fast and slow blood contractions, heart rate, pulse frequency amplitudes, decrease in dicrotic and diastolic indices and vascular tone. The results can be used by specialists - physicians and physiologists.

We surveyed 220 children, aged from 2 months to 14 years, patients with acute intestinal infections of a bacterial nature. Patients were comparable in diagnostic criteria and the severity of the disease. The use of the enterosgel resulted in a decrease in the duration of diarrhea, intoxication, vomiting, and reduction in bed-days, which ultimately reduced the costs of treatment and maintenance of patients.

Introduction: the study of carbohydrate metabolism disorders pathogenesis in patients with diabetes mellitus risk seems to be a promising research direction. The fundamental pathogenetic role of hyperinsulinism as a type 2 diabetes mellitus risk factor has been established in many prospective studies. Nowadays, the interlinks between the parameters of glycemic regulation and the phenomenon of its variability, which is the main factor in the total glycemic variability among the methods used today, is especially promising. The subject of our study in this article is the potential interactions between the HOMA-IR insulin resistance index and 1.5 anhydro-D-glycitol in patients with the ten-year risk of type 2 diabetes mellitus by FINDRISK scale. Materials and methods: 213 patients with risk factors for type 2 diabetes were recruited to the study. We provide collection of clinical data and such carbohydrate metabolism parameters as fasting blood glucose, glycosylated hemoglobin, insulin, 1,5 anhydro-D-glycitol in both study groups. Statistical processing was performed using Kruskal-Wallis one-way analysis of variance, Spearman rank correlation. Resuits and discussion: Significant positive correlation relationships between 1.5 AG and body mass index (r=0.213), waist circumference (r=0.260), systolic blood pressure (r=0.143), diastolic blood pressure (r=0.143), triglycerides (r=0.147), insulin (r=0.215), HOMA-IR (r=0.232), and FINDRISK (r=0.161). Conclusion: decreased 1,5-AG concentration is associated with a high risk of developing diabetes on the FINDRISK scale, which makes it a potentially useful marker for assessing the risk of developing metabolic disorders.

Colorectal cancer is one of the most frequently diagnosed malignant tumors in the world and the Republic of Kazakhstan. Currently, the studied genetic variations and environmental risk factors are attributed to the etiology of colorectal cancer. This study was aimed to search for polymorphisms associated with the development of colorectal adenocarcinoma in representatives of the population of Central Kazakhstan. A significant number of polymorphisms associated with colorectal cancer were localized on chromosome 12. Materials and methods: the study involved 441 participants. The test material was venous blood, from which DNA was isolated. Next, genotyping was performed using a QuantStudio 12K Flex PCR. Statistical processing included the following parameters, Pearson x2 test, determination of the odds ratio and 95% confidence intervals. The genotype -phenotype relationship was determined using the general linear model with multiple inheritance options. Results and discussion: all polymorphisms met the Hardy - Weinberg equilibrium. Four significant polymorphisms according to the x2 test had MAF associated with colorectal cancer risk. For them, an analysis of inheritance models was carried out on the basis of a log-additive model. The data obtained allowed us to speak of an increased risk of colorectal cancer for rs3217810 and a decrease in the risk for: rs7315438, rs2238126, rs11064437. Conclusion: we identified polymorphisms that are associated with the risk of colorectal cancer in the Kazakhstan population according to the log-additive model of inheritance and the distribution of minor allele frequencies. The research is experimental work, and the results are of scientific novelty.

A model was obtained to differentiate between patients with carotid artery remodeling and conventionally healthy people based on machine learning using genetic data from the Kazakh population For the period 2018-2020, 561 study participants were recruited, of which 357 had PCA and 204 were conditionally healthy. Genotyping was performed using QuantStudio TM 12K Flex Real-Time PCR technology (Applied Biosystems) using a panel of 118 polymorphisms. After the quality control procedure, 43 polymorphisms were excluded from further analysis. The results of genotyping of 75 polymorphisms were used to build a binary classification model in the form of a «decision tree» based on the Fast-and-frugal trees (FFTs) algorithm. The best model of 5 polymorphisms had 52% sensitivity, 64% specificity, and 56% accuracy in the ability to distinguish between RSA patients and conventionally healthy people based on genetic data.

The aim: to analyze the results of an objective structured clinical examination in an internship to understand ways to increase its effectiveness and improve the Clinical Competence of graduates of medical universities. Materials and methods: 272 interns of the specialty «general medicine» using the method of mathematical analysis evaluated the internal reliability of the examination as a whole and of individual stations (Cronbach's a); station difficulty level and discrimination; corrected item total correlation; «Cronbach's a if item deleted». Results and discussions: an objective structured clinical examination is a reliable (Cronbach's a=0,661) and appropriate (Discrimination 0,060-0,190) examination. This allows us to consider it an example of modern Educational Technology. Too complex and too simple stations not found. But the limit of difficulty (80,4 item) was reached at station №5 «Diagnosis and emergency care for a stroke at the prehospital stage». The smallest differences in student competence were observed at station №7, «Differential Diagnostics for Cyanosis in Children» (0,060) and the largest (0,190) at station №10 «Family Planning Advice». To resolve the issue of the internal reliability of stations, the characteristics of their rating sheets should be considered and evaluate inter-expert reliability

Active teaching methods and a competence-based approach are ways to update medical education in the Republic of Kazakhstan. In modern conditions, the quality of medical care is directly related to innovative teaching methods. Active teaching methods used at the Department of ophthalmology and otorhinolaryngology allow students to master the knowledge, skills and abilities necessary for professional activity, to master the skills of clinical thinking, to approach decision-making with great responsibility; they increase students' interest and the quality of material assimilation, efficiency and productivity of training, and develop their creative abilities.

The article discusses the experience of modernizing the methodology of teaching philosophy at the Medical University of Karaganda. It is implemented in accordance with the development strategy of university education in Kazakhstan. The authors emphasize the unity of pragmatism and liberalism in the modern understanding of the mission of the university. The task of modernizing the methodology of teaching philosophy in Kazakhstan universities is to implement it both as an educational discipline and as a way of thinking. The leading idea of Kant is put forward «not thoughts need to be taught, but thought». According to the authors, the new model program in philosophy for Kazakhstani universities in its structure corresponds to the post-non-classical paradigm of knowledge. Its methodological basis is a synergistic approach. The article analyzes the experience of refusing testing and replacing it with writing an essay as a form of the final control of students' knowledge of philosophy at the Medical University of Karaganda.

The article describes the experience of implementing and evaluating the effectiveness of active methods of teaching CBL and TBL when conducting practical classes for 4^th-year students of the specialty «General medicine» in the discipline «Children's diseases». A new approach to teaching medical students - the TBL (Team-Based Learning) method and the CBL (Case-Based Learning) method - is described in detail and proposed for use.

In the article, research work is a key task in the education system to expand the knowledge acquired by students, as well as to clarify and justify the forecasts of scientific work. Research-based learning (RBL) is a program where the learning process is fully integrated with literature. Encourage students to improve their research. Using this active method in medical practice, embed your results in articles in medical and research databases (Medline, Cochraine Library, PubMed, Google scientist, etc.).

The present study aimed to evaluate the cost - effectiveness of the drug «Xyltophy®» (insulin degludec U100 + liraglutide 3,6 mg, IDegLira) compared with typical basic-bolus therapy (basal insulin glurgin U100 plus bolus insulin aspart) in patients with type 2 diabetes mellitus. The costs associated with the cost of medicines and management were recorded from the period of view of the health care payer in 2020 prices in tenge. Discounting was not applied. It found that the use of the drug «Xyltophy®» is associated with high costs for the purchase of medicines (469 525,29 against 276 988,24 tenge), but this was fully compensated by lower costs for correction of episodes by hypoglycemia and in reducing the cost of management. All this leads to the fact that use of the drug «Xyltophy^®» is associated with a lower annual cost level (497 759,29 against 390 407,24 tenge) compared with the costs required when using insulin glargin U100 plus insulin aspart. The sensitivity analysis fully confirms the results of basic analysis. For the payer, the replacement of the standard basic - bolus therapy with insulin glargin U100 plus insulin aspart for the therapy drug «Xyltophy^®» can save the health care budget about 7,5 billion tenge in the first three year.

The aim is to develop and evaluate the reliability of the questionnaire for the assessment nurses’ professional commitment in the developing and improving safe environment in the hospital. Materials and methods: the questionnaire was developed based on the Nursing Safety and Quality of Patient Care Guidelines and the Schnall's Patient-Safety Attitudes, Skills and Knowledge (PS-ASK). Questionnaire validation included language and adaptation, expertise, pilot testing and the development of the final version. The questionnaire reliability was based on to calculate internal consistency correlations using Cronbach’s coefficient a. Results and discussion: linguistic adaptation did not reveal significant differences in the translated versions of the questionnaire. Marginal adjustments were made by the expert's commission to the phrasing of questions and their answers in order to facilitate understanding. The pilot test was attended by 50 nurses. The Cronbach coefficient was calculated for each study area and ranged from 0.457 to 0.898. Despite the low a Cronbach’s alpha indices on the scale, the attitude of the personnel to the manipulations of a safe environment, the overall Cronbach's alpha for the entire questionnaire is 0.823. Conclusions : According to the study, the developed questionnaire showed a satisfactory level of reliability and internal consistency. Thus, this questionnaire can be used to assess nurses' professional commitment in the developing and improving safe environment in the hospital.

The article presents the main stages of the development and validation of the questionnaires «Identifying barriers to men’s participation in perinatal care». As part of these works, the validity and reliability of the questionnaires were calculated. Statistical processing of the obtained results was carried out using IBM SPSS Statistics 26 and STATIS-TICA 12. The questionnaires were modified through peer review, expert validation and pilot testing. The questionnaire showed good constructive validity and internal reliability. These questionnaires represent a reliable tool for future research on male involvement in perinatal care.