Relevance. The prevalence of cervical ectopia varies from 17 to 59%. Cervical ectopia is diagnosed in 54.2% young women under 25 years of age. It is most often diagnosed during preventive examinations. Cervical ectopia is considered a variant of the normal histophysiological condition of the cervix. At the same time, it has been proven that in ectopia, the cylindrical epithelium with its crypts is the main and ideal place for the introduction of sexually transmitted infections. The complicated course of ectopia against the background of the inflammatory process is observed in 67.7-71.2% cases, contributes to the disruption of epithelial proliferation processes and can lead to the development of dysplasia and cellular atypism.
Aim. To analyze the literary sources devoted to cervical ectopia associated with sexually transmitted infections in young unborn women.
Materials and methods. The literary review and analysis of publications on the topic in sources indexed in e-Library, Google Academy, Pubmed databases. The keywords to search were cervical ectopia, human papillomavirus, and pathology of the uterus. The inclusion criteria were the reports on randomized and cohort studies conducted on large populations, meta-analyses and systematic reviews, original full-text articles in English and Russian, which are publicly available and contain statistically confirmed conclusions. The exclusion criteria were summary reports, newspaper articles and personal messages. The result of the relevant search was 1,200 articles, and 32 articles were selected for final analysis.
Results and discussion. The results showed that cervical ectopia associated with sexually transmitted infections, especially papillomavirus infection, occurs with high frequency among women of young reproductive age, which accordingly increases the risk of cervical cancer developing.
Conclusion. Thus, cervical ectopia is common among young women and adolescents, and is almost always associated with sexually transmitted infections.

Today, the use of autologous platelet-rich plasma expands the horizons of its use in medicine. However, to uncover the key factors of plasma effectiveness, more data is required, describing in detail the method of plasma preparation, the amount of material introduced, as well as data on a comparative analysis of various methods of its administration. The purpose of this review was to search for data on the use of autologous plasma in the fields of Anti-Age medicine, plastic surgery and dermatology with a description of the methodology, as well as local and general effects. Publications of foreign and domestic authors in the Scopus and Pubmed databases were analyzed. When searching using the keywords: platelet rich plasma, safety, effects, dermatology, cosmetology, surgery, melasma, acne, 570 publications were found. Taking into account the depth of the search (the last 5 years), the language of publications (Russian, English), 32 full-text articles were included in the analysis. The presence of a large number of studies demonstrates the high interest of scientists from all over the world in studying the properties and effectiveness of plasma. Positive results of using plasma were presented in the field of plastic surgery, cosmetology, and dermatology. However, the lack of a detailed description of the methodology of the procedure, and moreover, a unified standard algorithm for the procedure and criteria for admission to receiving plasma, creates difficulty in comparability of results, both positive and negative. Therefore, additional larger studies are required to help answer these unresolved questions.

Laparoscopic surgery, a cornerstone of contemporary surgical practice, revolutionizes traditional surgical techniques by employing minimally invasive procedures. However, this innovative approach poses intricate challenges, particularly in respiratory management, necessitating a comprehensive understanding of its physiological implications. Pneumoperitoneum involves insufflating the abdominal cavity with carbon dioxide (CO2) to create a suitable working space. The introduction of CO2 into the peritoneal cavity elevates intra-abdominal pressure, prompting physiological adaptations that compromise respiratory function. These alterations, including increased peak inspiratory pressure, decreased dynamic respiratory system compliance, and the promotion of intraoperative atelectasis, underscore the intricate interplay between pneumoperitoneum and respiratory physiology.
Amidst these challenges, positive end-expiratory pressure emerges as a crucial intervention for mitigating the adverse effects of pneumoperitoneum on respiratory mechanics. By maintaining airway patency and preventing alveolar collapse during expiration, positive end-expiratory pressure helps counteract the reduction in functional residual capacity associated with elevated intra-abdominal pressure. Additionally, positive endexpiratory pressure serves to optimize lung recruitment, thereby improving ventilation-perfusion matching and enhancing oxygenation.
Mechanical ventilation during laparoscopic procedures further complicates respiratory management, potentially exacerbating lung injury. The application of protective lung ventilation strategies, such as low tidal volume combined with judicious positive end-expiratory pressure titration, represents a cornerstone in mitigating ventilator-induced lung injury and reducing postoperative pulmonary complications. However, the optimal implementation of these strategies remains a subject of ongoing debate, highlighting the need for personalized approaches tailored to individual patient characteristics and surgical contexts.
Understanding the pivotal role of positive end-expiratory pressure in mitigating the adverse respiratory effects of pneumoperitoneum underscores its importance as a cornerstone intervention in laparoscopic surgery. By optimizing positive end-expiratory pressure levels based on patient characteristics and procedural requirements, healthcare practitioners can effectively mitigate the risk of pulmonary complications and enhance surgical outcomes.

The article presents a review of articles aimed at summarizing the results of studies using the choriollantoic membrane (СAM) to study markers and mechanisms of endometrial receptivity and angiogenesis. Considering these studies together clarifies the complex regulatory networks involved in vascular development and endometrial susceptibility. Understanding the intricacies of angiogenesis and endometrial susceptibility is crucial in reproductive medicine and infertility treatment. The chorioallantoic membrane (CAM) and its analogues, the angiogenic model derived from stroma (CAM), offer valuable platforms for such research. A comprehensive search of scientific literature databases was conducted to identify relevant studies using CAM. Studies using CAM have provided insight into markers of endometrial susceptibility, shedding light on structural changes associated with vascular development. Similarly, studies using CAM have provided valuable information on pinopods and other markers indicating endometrial susceptibility, indicating potential clinical applications in reproductive medicine. Together, these studies contribute to a deeper understanding of the cellular and molecular mechanisms of endometrial regulation. They emphasize the role of various factors, including growth factors, cytokines, and signaling pathways, in inducing endometrial angiogenesis and modulating its susceptibility. Such findings can serve as a basis for the development of new diagnostic and therapeutic strategies in reproductive medicine.

Introduction. The article notes that the greatest contribution to the structure of causes of death and disability associated with cardiovascular diseases identified as a result of the study falls on patients with arterial hypertension. Social and hygienic portrait of a patient with arterial hypertension. Age – most often occurs in people over 40 years of age, the most common age is 40-60 years, the highest incidence is observed in this age group. At this age, there is a physiological aging of the vessels and an increase in blood pressure. After over 60 years: the incidence increases and the detection of AG among older people increases significantly due to age-related changes in the circulatory system and the presence of concomitant diseases. Among men by gender, the incidence of hypertension is most often observed in men in young and middle age (up to 60 years). This is due to high levels of stress, alcohol consumption, smoking and a sedentary lifestyle. And among women, the difference in morbidity between the ages of 60 and older decreases, and women begin to suffer from hypertension as much as men. This can lead to an increase in blood pressure due to changes in the hormonal background, especially after menopause.In terms of social characteristics, a low level of education may predispose to not being aware of the risks associated with arterial hypertension, as well as a healthy lifestyle.
Aim. To characterize the modern socio-hygienic characteristics of the personality of patients with arterial hypertension.
Materials and methods. A comprehensive medical and sociological study was conducted from 2020 to 2023 on the basis of Karaganda city polyclinic No. 3. The research program is implemented in accordance with the goals and objectives of the doctoral work, and the research practice is based on specific criteria. Results and discussion. Among the respondents, the largest number were patients aged 54-62 years (N = 241; 58.1%). In addition, the proportion of representatives of this age group among the women surveyed exceeded the statistically significant (p<0.05) similar indicator among men (67.4 and 45.3%, respectively).
Conclusion. The results of our study confirm that, like other authors who conducted similar studies when planning and implementing preventive measures related to hypertension, men of working age should be especially attentive as a category of people with more pronounced risk factors for hypertension and rarely spread to medical organizations.

In a retrospective analysis of statistical accounting of tuberculosis incidence for 3-6-9-12 months of 2019, 2020 and 2021 in Akmola region, statistical reporting data from the Akmola Regional Center for Phthisiopulmonology named after Konyratbek Kurmanbayev and the Republican Center for E-Health were used.
The authors concluded that due to the pandemic and the introduction of a state of emergency in the Republic of Kazakhstan, including in the Akmola region, the main attention of the medical service was paid to the fight against coronavirus, therefore, the active detection of tuberculosis during the pandemic decreased in the whole region (by 17.6%) and by districts (by 25.7%). However, a year after the start of the pandemic (2021), an improvement in the activity of the tuberculosis service was registered in the region, districts and polyclinics of Kokshetau, i.e. in connection with the timely detection of tuberculosis in 2021. The epidemiological situation has stabilized and as the work on early and timely detection of tuberculosis has improved and the epidemiological situation has stabilized, the incidence of complicated forms of tuberculosis has decreased.

Introduction. Idiopathic pulmonary arterial hypertension (IPAH) is a subtype of pulmonary arterial hypertension (PAH). IPAH is characterized by a progressive increase in pulmonary vascular resistance (PVR), which can lead to right ventricular heart failure and even mortality. The aim was to study the levels of C-reactive protein (CRP), endothelin-1 (ET-1) and interleukin-6 (IL-6) in patients with IPAH, as well as to assess their relationship with clinical and hemodynamic parameters.
Materials and methods. Expression of CRP, ET-1 and IL-6 in blood serum samples of patients with IPAH (n=53) and control group (n=52) of the appropriate age/gender was determined using enzyme immunoassay (ELISA). Demographic, clinical characteristics and hemodynamic parameters were studied in patients with IPAH according to catheterization of the right heart (CRH).
Result and discussion. The average age range of patients with IPAH was 35.0-51.0 years, there were 46 (86.8%) women in this group. The average age of the participants in the control group was 31.0-42.0 years, there were 46 (88.5%) women. The levels of ET-1 (p < .016) and IL-6 (p < .001) were higher in patients with IPAH compared to patients in the control group, whereas the level of CRP (p = .270) was no different. Meanwhile, the level of ET-1 positively correlated with the average pressure in the right atrium (r = .728, p < .001) and pulmonary vascular resistance (r = .360, p = .008), while IL-6 positively correlated with the functional class of heart failure according to the classification of the New York Heart Association (NYHA FC).
Conclusion. Levels of IL-6 and ET-1 can be included in the diagnostic algorithm for assessing the severity and prognosis of the disease.

Aim of the study. To evaluate the relationship of prognostic laboratory markers of habitual miscarriage with histological pregnancy outcomes.
Materials and methods. A retrospective study was conducted with an analysis of the histological outcomes of pregnancy, and their relationship with the main prognostic laboratory markers. The study included 56 women of reproductive age who sought medical help in a hospital due to reproductive loss up to 12 weeks of pregnancy with a history of two or more adverse pregnancy outcomes. A statistical analysis of the relationship between histological pregnancy outcomes and prognostic laboratory markers of reproductive loss was carried out.
Results and discussion. In our study, we found a statistically significant difference between group 1 and group 2. Thus, the quartile ranges of IL-6 were 5,730 – 8,840 and 3,540 – 6,910, respectively, which can serve as a prerequisite for the formation of reference values for predicting inflammatory factors at the pre-gravidar stage. Significant statistical differences between groups 1 and 2 in terms of TM were also obtained. Thus, the quartile ranges were 5,430 – 6,510 in group 1 and 7,120 – 9,030 in group 2, which shows a significant correlation between laboratory markers of analysis and the results of histological studies in the form of hemorrhagic changes.
Conclusions. According to the analysis of histological outcomes of pregnancy up to 12 weeks in the population of women in Kazakhstan, the main causes are inflammatory and hemorrhagic disorders. As the most significant prognostic laboratory criteria, as a result of the study, IL-6 can be identified as a predisposing factor for the presence of inflammatory causes of reproductive losses and thrombomodulin, as the gold standard for identifying coagulation and hemorrhagic causes of habitual miscarriage.

Aim of the study. To study the frequency of isolation of Staphylococcus aureus from clinical biomaterials of patients with purulent-inflammatory diseases for the period from 2018 to 2022 according to the microbiological laboratory of JSC «National Scientific Medical Center», Astana.
Materials and methods. A prospective microbiological study of the microbial landscape isolated from clinical samples of inpatients with purulent-inflammatory processes was carried out. Isolation and identification of strains was carried out on the basis of the microbiological laboratory of JSC «National Scientific Medical Center», Astana.
Results and discussion. According to the microbiological laboratory of JSC «National Scientific Medical Center», during the period of bacteriological studies of clinical materials from patients with purulent-inflammatory diseases of various localization and from other materials used in medical institutions, from 2018 to 2022, a total of 961 strains of Staphylococcus aureus were isolated. When studying the dynamics of growth or decrease in the number over the years, it can be noted that for all the periods of study, we noted the most significant increase in the release of the amount of Staphylococcus aureus only from samples taken from the throat – 57.4%. In second place in terms of the frequency of Staphylococcus aureus discharge is a wound – 15%, in third place urine – 6.13%, followed by a nasal smear – 3.64% and sputum – 2.49%, respectively.
Conclusion. Thus, one of the dominant pathogens in purulent-inflammatory diseases is Staphylococcus aureus and the main clinical biomaterial according to the frequency of detection during bacteriological examination of patients taken from non-infectious clinics from 2018 to 2022, according to the microbiological laboratory of JSC «NSMC» there was a throat smear, which accounted for 57.4%, then wound – 15% and urine – 6.13%. In the remaining biomaterials, the detection of Staphylococcus aureus was insignificant

Aim of the study. The article is devoted to the current trend of modern orthopedics – the surgical treatment of local full-thickness defects in the hyaline cartilage of the knee joint. This pathology is diagnosed in 5-10% of patients with diseases and injuries of the knee joint.
Materials and methods. The authors of the article presented one of the most modern and available technologies for the restoration of cartilage defects – the implantation of Heparin-Conjugated Fibrin Hydrogel. This operation technique was used in 38 patients. The article presents the indications and technique of surgery, criteria for evaluating treatment outcomes.
Results and discussion. Treatment outcomes in terms of up to 2 years were studied in 38 patients. Good treatment results were observed in 33 patients. In all cases, high-quality and regeneration of the cartilaginous surface of the femoral condyles was achieved.
Conclusion. Analysis of the outcomes of treatment of patients after implantation implantation of Heparin- Conjugated Fibrin Hydrogel allows the authors of the article to recommend this technique for widespread use in clinical practice.

The author of the article declares that the pathogenesis of the connection between HIV infection and cancer is an urgent problem for research at the present time and suggests studying the level of cancer biomarkers in a group of HIV-infected patients who used narcotic drugs in the past and in a healthy control group using immunological methods and statistical analysis methods.
The author clarifies that a selection of blood biomarkers can be useful for diagnosing the cause of infections, as well as for identifying cases when HIV infection turns into neoplasia. Clinical examinations of HIV patients and the results of laboratory studies on specific blood biomarkers provide a lot of information for clinical decision-making. Laboratory diagnostic methods are necessary for monitoring HIV infection and contribute to the proper quality of life of patients diagnosed with HIV.

Aim of the study. To evaluate the availability of pharmacological treatment and the relevance of recommendations presented in clinical protocols in the field of «Adult Urology» through a comparative analysis of international experience and to identify aspects for improving protocols in this field.
Materials and methods. The materials used were current clinical protocols for diagnosis and treatment in the field of «Adult Urology» available on the official website of the National Scientific Center for Healthcare Development, international recommendations of the constantly updated database of guidelines for decision support in clinical practice British Medical Journal Best Practice, guidelines of the European Association of Urologists, guidelines, reviews of the UpToDate resource, providing medical professionals with relevant and evidence-based information.
Results and discussion. Urological diseases are often complex, multifactorial conditions; it is impossible to encompass all treatment regimens for every clinical scenario. Nonetheless, it is necessary to broaden the scope of this profile by developing clinical protocols depending on the etiological factor, extent of involvement, and stage of medical intervention. Upon reviewing clinical protocols in the field of «Adult Urology» the following common deviations were identified regarding pharmacotherapy: irrational selection of antibacterial agents, routine use of antifungal prophylaxis, use of medications with low levels of evidence, dosing regimen errors, and the use of trade names in the protocol text, which constitutes a blatant violation of the ethical promotion policy of pharmaceuticals. Antibiotic therapy is recommended only for confirmed bacteriuria with broadspectrum antibiotics. Antifungal prophylaxis is recommended only for patients at risk (secondary or primary immunodeficiency).
Conclusions. Currently, 100% of clinical protocols in the field of «Adult Urology» are outdated and require revision. The rapid advancement of science, development, and improvement of pharmaceuticals necessitates ongoing professional development on the part of healthcare personnel, which can be facilitated by regular updating of clinical protocols. The availability of pharmacological therapy for urological patients is quite high: 97.35% medications presented in clinical protocols are available to patients in the Kazakhstani market (registered and included in the Kazakhstani National Drug Formulary), 94.7% medications are reimbursed within the framework of outpatient care, and 90.9% medications are available for procurement by medical organizations through the Single Distributor.

Aim of the study. Analysis of satisfaction with hospitalization in the gynecology department using service design.
Materials and methods. The study used a service design, including observation and interviews with 18 respondents (12 patients and 6 nurses) in the gynecological department of the Municipal State Enterprise on the Right of Economic Management «Multidisciplinary hospital named after prof. Kh. Zh. Makazhanov». The study, conducted from October to December 2023, included data analysis by a team of two researchers using content analysis.
Results and discussion. The study revealed problems in organizing hospitalizations of patients in the gynecological department. In order to improve the efficiency of hospitalization, a solution to problems with long waits and inconvenience for patients, as well as improving communication and empathy of medical staff, was proposed.
Conclusion. Increasing patient awareness, ensuring comfort and confidentiality, optimizing admission processes and providing psychological support are highlighted as priority areas.

The issues of geriatric service development in the aspect of relevance, development of regulatory and resource base are considered. Taking into account the world trends, the validity of geriatrics development at the interdisciplinary level has been analyzed. The situation of geriatrics development in the country is considered taking into account the stage-by-stage multilevel resolution of geriatric service improvement taking into account the trinity of “practice-sciences-education”. Analyzed the situation and development of conditions and resources for the development of gerontological service in the country. Actualized on the basis of official data the deficit of specialists to serve the age category of clients for the provision of medical service. At the same time, the cost of providing medical service to patients ≤65+ was noted. The development of training programs in the specialty of «geriatrics» within the framework of continuing professional education makes it possible to fill the shortage of specialists. The development of the resource base requires more improvement to improve the quality of life of the age category of the population and leveling the burden on the health care system with improved performance of the outcomes of resource management processes in the field of geriatrics. Actualization of legal and regulatory and normative base of geriatric service and their complementarity with normative and legal acts in the field of palliative care creates conditions for improvement in the implementation of practical processes of geriatric service. Taking into account the global trend and progress in the promotion of geriatric service within the country, the prerequisites for effective implementation of practice within the specialty “geriatrics” have been created.

Aim of the study. To study the prospects for using the ChatGPT tool with artificial intelligence in the training of pharmaceutical workers.
Materials and methods. A review of the literature on the topic of the article in the Scopus and RSCI databases for the period from 2020 to 2024 was conducted, and the materials of the results of using the ChatGPT artificial intelligence tool (versions 3.5 and 4.0) in the educational process of student pharmacists were analyzed.
Results and discussion. The article discusses the experience of using the ChatGPT chatbot artificial intelligence tool by foreign scientists in the pharmaceutical field, both in various aspects of life and in educational and professional activities. The prospects for using the ChatGPT AI tool in the educational process in the training of pharmaceutical personnel at the School of Pharmacy of the Karaganda Medical University were studied. As a result of the analysis, both the positive aspects and risks of using ChatGPT in pedagogical activities were discussed.
Conclusions. The obtained data indicate that the possibilities of using AI ChatGPT in society are not limited to entertainment purposes only. They also include educational purposes and provide opportunities for selfdevelopment and self-learning through interaction with the chatbot.

Master's thesis in the system of science performs a qualifying function, i.e. it is prepared for the purpose of public defense and obtaining a scientific degree. Therefore, the compliance of such research with the basic requirements (justification of the relevance of the topic and methodological approach; correspondence of the goal, objectives and conclusions; subject and object, etc.) is fundamental in the preparation of master's theses. However, first-year master's students generally do not have basic research competencies, cannot choose and show the relevance of the topic, formulate the goal and objectives, determine the novelty and practical significance of their scientific work. In addition, having a limit time to choose and approve a relevant topic, without a pilot study, they often make a number of significant mistakes when preparing and defending their dissertation work.
The article discusses the peculiarities of preparing a qualifying research paper in the master's program using modern educational technologies and algorithms. To solve these problems, in order to effectively help the novice researcher, the authors consider it necessary to use a technological approach in the preparation of qualification work, which is useful in terms of unifying the actions of the student, ensuring the reproducibility of research steps and achieving a guaranteed result.
For this purpose, the authors have compiled and proposed, for use in classes with master's students, a step-by-step structured algorithm of actions aimed at solving research problems. And eligibility is a diagnostic indicator of the achievement of the learning goal and objectives. The developed step-by-step algorithm is used in the discipline «Technology of preparation of master's research», which is conducted for master's students of Karaganda Medical University, studying in various specialties.

Personnel training is one of the key points regulated by the Good Manufacturing Practice standard. A wellstructured and established training system in pharmaceutical production is an important aspect to ensure the quality of all processes in the company, thus ensuring the quality, efficiency, and safety of the products, drugs, and/or medical devices manufactured at the enterprise. The evaluation of training quality plays a decisive role in the effective functioning and improvement of the pharmaceutical production training system and the achievement of desired results. Education evaluation methods evolve and improve over time, reflecting changing models and modern requirements. This article presents four main models for evaluating the quality of a training system for comparison: the Kirkpatrick model, the Phillips model, the Stufflebeam model, and the Bern model.
The Kirkpatrick model, based on four levels of evaluation - reaction, learning, behavior, and results, is widely used due to its simplicity and practicality. The Phillips model focuses on evaluating investment in training and its impact on business results. The Stufflebeam model, focused on evaluating the training process, offers a system of multiple data collection methods for continuous improvement of training quality. The Bern model proposes an integrated approach to evaluation, including both qualitative and quantitative evaluation methods.
Each of these models has its advantages and disadvantages, and their choice depends on the specific educational and organizational needs of pharmaceutical production. It is important to consider the context and objectives of the evaluation to choose the most suitable model for a particular situation.

The authors present the clinical case as an example of a possible way to reduce maternal mortality from amniotic fluid embolism, timely diagnosis and treatment in order to save the mother's life.
The study describes a rare clinical case of amniotic fluid embolism, successfully cured with the help of multi-disciplinary treatment, which was treated at the RSE at the Regional Perinatal Center No. 1 (Turkestan region, Kazakhstan) in 2024.
Additional examinations were carried out in a timely manner: electrocardiograms, echocardiography, chest X-ray, specialist consultations: a therapist, an optometrist, a neurologist, a cardiologist. A multidisciplinary consultation with narrow specialists was held in a timely manner and, according to the recommendations of consultants; a correction in appointments was carried out. The medical team and anesthesiologists played a big role in saving the mother's life.
The presented clinical case shows that obstetricians, gynecologists, and intensive care specialists should pay attention to assessing the presence of predisposing factors for the development of EOV in each individual.