This review article is devoted to the analysis of current data on the problems of diagnosis and treatment of chronic kidney disease in elderly and senile patients with comorbid pathologies. The work considers the main comorbid pathologies in combination with chronic kidney disease. Based on the analysis of modern literature, key areas for further research are identified. The data obtained emphasize the importance of a separate approach to the diagnosis and treatment of this disease in elderly and senile patients with comorbid pathology.

The literature review highlights the need for an integrated approach to the management of elderly and senile patients with comorbid pathology, including early diagnosis, careful assessment of comorbid conditions, and timely initiation of treatment aimed at slowing the progression of the disease and improving quality of life. In the future, additional research is required to better understand the mechanisms of interaction of chronic kidney disease with other diseases in elderly patients, as well as to develop new approaches to diagnosis and treatment.

In healthcare, nursing errors are problematic. This is since the nursing process is multitasking from providing the prescribed intervention by other specialists to independent planning, implementation and evaluation of care effectiveness. In addition, caring for patients with cancer presents unique challenges that may contribute to the risk of error. However, nursing omissions are not given enough attention, which leads to the spread of this phenomenon in nursing practice. In Kazakhstan, errors in nursing practice are not considered as a separate concept.

The objective of this review is to study the phenomenon of errors in nursing practice to expand understanding and improve the nursing care process for patients with cancer.

The literature search was conducted in electronic databases, including PubMed, PSNet, Google Scholar. The search strategy incorporated specific Medical Subject Headings (MeSH) terms: « oncology » , « nurse » , « error » , « nursing » , « chemotherapy » . The inclusion criteria were publications containing information on nursing omissions and/or errors at all stages of the treatment and diagnostic process, including in oncology practice.

This review has provided a deeper revealing and understanding of the phenomenon of nursing errors in practical healthcare, including the specifics of clinical oncology. Nursing practice in oncology cannot be errorfree. Despite this, healthcare organizations should develop analysis of the potential for failures within and between systems, a culture of compliance with standards, medical communication, and a system for reporting and disclosing errors. A successful strategy for minimizing errors in clinical oncology is to develop awareness of patient safety among nurses.

Electronic registries help improve the overall understanding of supervised patients and assess the feasibility and effectiveness of diagnostic, preventive, and therapeutic interventions for certain types of diseases. Analytical data from patient registries can be used to supplement international clinical guidelines, standards, and screening programs. Controlled trial registries and clinical trial registries help generate reports on increased risk of certain diseases, identify unreported associations, confirm or refute previously reported associations with severe pathologies, and expand the existing spectrum and phenotype of the disease.

Disease registries, national clinical registries, portals, databases, registers of medical services and other information systems have already demonstrated many advantages, such as new ideas, additional basic knowledge, increased awareness, unique opportunities for researching population data, morbidity, treatment approaches and act as proven statistical tools. The main purpose and benefit of registries in medicine is to guide future efforts that will close knowledge gaps, improve disease management and prevention models.

Drinking water quality remains one of the key determinants of public health and sanitary-epidemiological well-being. Despite the progress with access to centralized water supply systems in the Republic of Kazakhstan, several medical and social challenges remain, including unequal access to safe drinking water, particularly in rural areas, deteriorating infrastructure, contamination of surface and groundwater sources, and insufficient efficiency of water treatment and quality monitoring systems.

The aim of this review was to analyze current scientific data on the major issues of drinking water supply and the impact of water quality on public health in Kazakhstan. This review used a combined approach, including the analysis of scientific literature, international reports and official statistical data. Searches were conducted using the PubMed, Scopus, Web of Science, eLibrary, and Google Scholar databases, as well as official websites of the WHO, UNICEF, the World Bank, and governmental authorities of the Republic of Kazakhstan. A total of 38 sources were included in the review. The findings indicate that drinking water in several regions of Kazakhstan exceeds permissible limits for certain chemical parameters, including nitrates, arsenic, lead, iron and mercury, due to both natural geochemical characteristics and anthropogenic impacts. Cases of microbiological contamination have also been reported, particularly in rural areas and during flood periods. Potential risks associated with both conventional and emerging contaminants, including PFAS and microplastics, are analyzed. Long-term consumption of contaminated water is associated with an increased risk of infectious, cardiovascular, oncological, nephrological, and reproductive disorders, especially among vulnerable population groups. A comparative analysis of drinking water quality standards in the Republic of Kazakhstan, the WHO, and the EU revealed that national regulations are less stringent for certain carcinogenic substances. The findings highlight the need to modernize water supply infrastructure, improve the regulatory framework, strengthen laboratory monitoring, and implement advanced water treatment technologies to ensure access to safe drinking water for the population of Kazakhstan.

Ameloblastoma is the most clinically significant benign epithelial odontogenic tumour, characterised by locally aggressive growth and a marked tendency to recur; up to eighty percent of these tumours arise in the mandible, predominantly in the molar, angle and ramus regions.

The aim of this review was to systematise current data on the classification, molecular basis, diagnosis, surgical treatment and mandibular reconstruction of ameloblastoma.

The literature was searched in the PubMed, ScienceDirect, eLibrary and CyberLeninka databases using the keywords ameloblastoma, mandible, odontogenic tumours, recurrence and reconstruction; systematic reviews, meta-analyses, original studies, clinical observations and fundamental manuals, mainly from the last two decades, were selected and synthesised qualitatively.

The review addresses the classification of the tumour according to the fifth edition of the World Health Organization classification of head and neck tumours (2022), the molecular and genetic mechanisms of its development (alterations of signalling pathways involving the BRAF and SMO genes), the principles of radiological diagnosis with the leading role of cone-beam computed tomography, the histological variants and special forms (unicystic, desmoplastic, peripheral and metastasising), and the surgical treatment strategy. Data on recurrence rates after conservative and radical interventions are analysed, and the role of adequate resection margins is substantiated. Modern methods of bone and alloplastic reconstruction of the mandible are considered separately, including reconstruction titanium plates, vascularised flaps and custom-made titanium constructions manufactured using digital design and virtual surgical planning. It is concluded that an individualised approach to diagnosis, radical treatment and reconstruction is required.

Medical air services constitute one of the key components of emergency medical care, enabling the transport of patients, medical teams, specialist physicians, donor organs, medical equipment, and biological materials in situations where ground transportation cannot provide timely access to specialized care. This topic is of particular importance for the Republic of Kazakhstan due to the country’s vast territory, the remoteness of many settlements from multidisciplinary and highly specialized medical centers, regional disparities in transport infrastructure, and the need for interhospital transfer of patients with critical conditions.

The aim of this review is to synthesize evidence from the scientific literature and official sources on coordination mechanisms for medical air services within emergency medical care systems and to identify opportunities for their improvement in the context of the Republic of Kazakhstan. The review includes publications addressing medical air services, helicopter emergency medical services (HEMS), fixed-wing aeromedical evacuation, interhospital transport, clinical prioritization, dispatch systems, telemedicine, digital clinical decision-support tools, training of aeromedical teams, quality assessment, mission cancellations, overutilization of air transport, and emergency and disaster management.

The current literature demonstrates that the effectiveness of medical air services depends not only on the availability of aircraft but also on the quality of coordination among healthcare organizations, regional coordination centers, aviation operators, receiving hospitals, and the national coordination authority. International evidence indicates that, in the absence of standardized activation criteria, digital resource management, and systematic auditing of dispatch decisions, medical air services may be either overutilized or activated too late for patients who genuinely require urgent specialized care.

For Kazakhstan, the most appropriate approach is a three-tier centralized digital dispatch model, in which the National Coordination Center for Emergency Medicine serves as the national coordination hub, regional coordination centers ensure the operational coordination of requests and available resources, and healthcare organizations submit standardized clinical information. Further development of the system should include standardized activation criteria for medical air services, a digital referral and dispatch pathway, telemedicinebased assessment of indications, real-time monitoring of aircraft and crew availability, confirmation of receiving hospital readiness, interregional coordination when local resources are insufficient, and routine auditing of completed, cancelled, and declined missions.

Currently, arterial hypertension is considered as one of the most significant public health problems, since this disease is becoming more common among people of working age every year and leads to an increase in medical and economic costs.

In the course of the study, the authors conclude that the prevalence of hypertension in Karaganda and Ulytau regions directly depends on the level of urbanization and regional characteristics: in urban, especially industrial areas, with a high incidence of hypertension, significant fluctuations are recorded among rural areas (the highest rate in the Abai region 204, the lowest in Karkaralinsky district 41). These differences are due, on the one hand, to the negative impact of industrial and environmental stress (coal mining, atmospheric air pollution). on the vascular system, on the other hand, the spread of a lifestyle close to urbanization (physical inactivity, psychoemotional stress, poor nutrition), as well as the age structure of the population (a high proportion of the middle and elderly population) and the high availability of medical care and the level of screening detection, which, in turn, contributes to an increase in the number of registered patients.

Introduction. Many countries, including Kazakhstan, aim to achieve universal health coverage and reduce health disparities, focusing on promoting healthy lifestyles, preventing injuries, and ensuring sustainable healthcare financing. This study seeks to analyze regional differences in premature mortality from injuries across six regions of Kazakhstan to better understand the impact of injuries, which remain a leading cause of death despite a slight decrease in overall injury-related fatalities.

Materials and methods. We calculated premature mortality rates (PMR) for individuals under 75 years of age using data from the National Scientific Center for Health Development, covering 2014 to 2021, and categorized by sex and aligned with ICD-10 focusing on accidents and injuries. Absolute and relative changes in PMR were computed to assess both the overall change in mortality rates and the rate of change over the defined period.

Results and discussion. North Kazakhstan experienced the highest premature mortality rates, rising from 148.15 in 2014 to 188.80 in 2021, while Atyrau had the lowest, with fluctuations from 69.54 in 2014 to 111.17 in 2021. East Kazakhstan recorded the highest relative change in mortality (63.3%), with males at 62.5% and females at 63.4%, while Atyrau showed a notable male increase of 74.6% but a smaller female increase of 23.5%, resulting in a combined total of 59.9%. In terms of total absolute changes, East Kazakhstan led with 83.76, followed by Akmola at 55.22 and West Kazakhstan at 53.96, while Zhambyl had the lowest at 26.26.

Conclusion. The data highlights significant regional and gender disparities in premature mortality in Kazakhstan, emphasizing the need for targeted healthcare interventions and policies that address these specific differences.

Aim . To determine the effectiveness of simultaneous combined surgical treatment of combined pathology of the nasopharynx, nasal cavity and middle ear in children with otitis media with effusion using radio wave surgery.

Materials and methods . The results of examination and treatment of 34 children aged 3 to 14 years before and after simultaneous surgical treatment of adenoids, vasomotor rhinitis and otitis media with effusion for the period 2022 2025 were studied. The surgical treatment used the Surgitron radio wave surgical device (ELLMAN International, USA), the operating microscope (Carl Zeiss AG, Germany), the tympanostomy tubes (Heinz Kurz GmbH, Germany), and endoscopic equipment.

Results and discussion . Hearing restoration according to tonal threshold audiometry was recorded in 33 (97%) children. According to the results of acoustic impedancometry, type A tympanogram was observed in 32 (94.1%) children, type C in 2 (5.9%). Relapse after 6 months was diagnosed in 1 (3%) child, and it subsequently required repeated tympanostomy.

Conclusions . Adenotomy and radio wave coagulation of the nasal concha significantly increases the effectiveness of treatment in children with impaired nasal breathing. Tympanostomy remains the most effective method of rapid and permanent hearing restoration in children with exudative otitis media. Endoscopic technologies make it possible to simultaneously, bloodlessly, and atraumatically improve the accuracy of operations and reduce the frequency of relapses.

Introduction . Dermatoscopy and bioengineering methods are high-value non-invasive diagnostic tools used to differentiate between eczema and xerosis, which often present with similar clinical features. Although both pathologies are characterized by skin dryness, their morphological and functional natures differ significantly.

Aim . To comparatively characterize the dermatoscopic signs and biophysical indicators of eczema and xerosis, to study the morphofunctional features of eczema and skin xerosis and to identify objective criteria for the differential diagnosis of these pathologies based on dermatoscopic signs and biophysical indicators (corneometry, sebometry, pH-metry).

Materials and methods . The study involved 32 patients with eczema and 27 patients with xerosis. The comprehensive diagnostic approach was employed: morphological changes were examined using polarized dermatoscopy, while the functional state of the skin was assessed through pH-metry, corneometry (moisture measurement) and sebometry (lipid level evaluation).

Results and discussion . In dermatoscopy, yellowish scales and an irregular arrangement of dotted vessels were characteristic for eczema, while thin white scales and an avascular background were the main markers for xerosis. Functional analysis revealed significantly lower skin hydration and lipid levels in the xerosis group, as well as changes in skin surface pH values. According to the Youden index, the avascular background, lipid deficiency, and pH-metric data had the highest value in clarifying the diagnosis of xerosis.

Conclusion . Combining dermoscopy with the results of pH-metry, corneometry, and sebumetry allowed for objective assessment of the «acid mantle» and the functional state of the skin, thereby enabling high-precision differentiation between eczema and xerosis.

Aim. To assess longitudinal changes in disability defined by the EDSS scale from the time of diagnosis to the end of the follow-up period, as well as to study transitions between disability categories and their association with disease duration in patients with multiple sclerosis in Azerbaijan.

Materials and methods. A longitudinal observational study with retrospective and prospective components was conducted for 2013 2022. The analysis included 238 patients with confirmed multiple sclerosis who had EDSS data at diagnosis and at the end of the study. Disability was classified as mild (EDSS 0 3.5), moderate (4.0 6.5), and severe (7.0 9.5). The Wilcoxon signed-rank test, Pearson’s χ[2] test, Cramer’s V coefficient, Kruskal Wallis test, and Mann Whitney U test were used.

Results and discussion. At diagnosis, mild disability was identified in 189 (79.4%) patients, and moderate disability in 49 (20.6%). By the end of the study, the proportion of mild disability decreased to 41.6%, moderate disability increased to 43.3%, and severe disability developed in 15.1% of patients. The median EDSS increased from 2.0 [1.0 3.0] to 4.3 [3.0 6.0], and the median ΔEDSS was 2.5 [1.0 3.0] (p<0.001). The baseline EDSS category was closely associated with the final level of disability (χ[2] (2)=104.935; p<0.001; Cramer’s V=0.664). Longer disease duration was associated with transition to more severe EDSS categories.

Conclusions . Significant EDSS progression was observed in patients with multiple sclerosis in Azerbaijan. Baseline EDSS and disease duration may be considered practical indicators of the risk of subsequent disability.

Aim. Development and experimental characterization of a bioactive composite based on polylactic acid, modified with hydroxyapatite and gentamicin, for implant applications.

Materials and methods. PLA-based composites were prepared by solution mixing followed by hot pressing, with variation of the hydroxyapatite content (0 40 wt. %). The microstructure and distribution of the inorganic filler were analyzed using scanning electron microscopy and energy-dispersive X-ray analysis. Mechanical properties were evaluated by three-point bending tests with determination of flexural strength and Young’s modulus in accordance with ISO 178:2019. Antimicrobial activity was assessed in vitro by the agar diffusion method against standard test strains of Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans.

Results and discussion. The developed composite fabrication approach was shown to provide a homogeneous microstructure with a dispersed distribution of hydroxyapatite within the polymer matrix without pronounced macro-agglomeration. An increase in hydroxyapatite content resulted in a systematic decrease in flexural strength accompanied by a moderate increase in Young’s modulus, reflecting the trade-off between stiffness and resistance to bending deformations characteristic of particulate-filled polymer systems. Gentamicin-containing composites exhibited pronounced antimicrobial activity against Gram-positive and Gram-negative bacteria.

Conclusions. The obtained results confirm the potential of PLA-based composites modified with hydroxyapatite and gentamicin as functional biodegradable materials for implant applications in regions with moderate mechanical loading, combining mechanical support, bioactivity, and local antimicrobial protection.

Time series forecasting is a pivotal tool across multiple disciplines, particularly in epidemiology, where precise predictions can guide resource allocation and inform public health strategies. This study explores the application of Seasonal Autoregressive Integrated Moving Average (SARIMA) models for short-term forecasting of time series data, using epidemiological data from Kazakhstan related to COVID-19 as a practical case study. The dataset encompasses total confirmed cases, daily ambulatory care patients, and daily hospitalized patients, spanning from May 30, 2022, to December 14, 2022, with forecasts extending 10 days forward to December 24, 2022. The analysis leverages SARIMA’s ability to capture both seasonal and non-stationary patterns, making it highly effective for modeling complex epidemiological dynamics.

The methodology involves several key steps: data preprocessing through natural-log transformation to stabilize variance, stationarity testing using autocorrelation function (ACF) plots, and differencing to address non-stationarity. The optimal SARIMA models identified were (5,3,1)(1,1,0)_7 for total cases, (1,2,2)(0,1,1)_7 for ambulatory care patients, and (2,2,1)(2,1,1)_7 for hospitalized patients, with forecasting accuracies of 99%, 97%, and 91%, respectively. These high accuracies, measured via Mean Absolute Percentage Error (MAPE), underscore SARIMA’s robustness in short-term predictions. Residual analysis, including Shapiro-Wilk and Ljung-Box tests, confirmed that the models’ residuals were normally distributed and independent, validating their suitability for forecasting.

This study highlights SARIMA’s versatility in capturing weekly seasonal patterns, as observed in the 7-day cycles within the COVID-19 data, which reflect reporting or behavioral trends. While the example focuses on epidemiological data, the methodology is broadly applicable to other domains, such as ecological monitoring or economic forecasting, where seasonal time series are prevalent. The findings demonstrate that SARIMA models provide a reliable framework for short-term forecasting, offering actionable insights for public health interventions and resource planning, with the COVID-19 dataset serving as an illustrative example of the approach’s efficacy and adaptability.

In the presented article, the role of the International Classification of Functioning, Limitations of Life and Health of a person is considered, which allows young specialists and interns to practice independently from the first days: 1) to conduct a comprehensive analysis of the patient’s existing life limitations; 2) to change the level and vector of building programs not only medical, but also social and environmental rehabilitation; 3) clarify the sequence of the complex of rehabilitation measures for supervised patients; 4) assess the effectiveness of the rehabilitation. An example of an analysis of an outpatient case of a patient is given, which, by analogy, can be successfully used during training sessions with students of medical universities for the best adaptation of future specialists to clinical practice.