Annotation

This article addresses a pressing issue in modern neonatology, focusing on a clinical case involving a patient with congenital leukemia. Congenital leukemia, being an extremely rare and severe form of leukemia, significantly contributes to high mortality rates among children during the early neonatal period. The article offers a literature review on acute leukemia in children, discusses the pathogenesis and clinical features of congenital leukemia, and presents a clinical case highlighting the incorrect approaches taken by a neonatologist at a maternity hospital and a pediatrician at a children's polyclinic in managing this condition.

In our view, this case underscores the importance of vigilance among neonatologists not only regarding intrauterine infections but also concerning blood diseases, including malignancies, which may present clinical manifestations during the early neonatal period. We believe that early detection of clinical signs and subtle blood abnormalities in newborns will enable neonatologists to conduct comprehensive evaluations of such children, facilitating the differential diagnosis of pathological conditions with similar clinical and laboratory presentations.

Annotation

One of the achievements during the years of independence has been the search for and revival of historical heritage. This endeavor has been facilitated by various events conducted as part of the implementation of the programs of the President of the Republic of Kazakhstan, namely "Madeni Mura" (Cultural Heritage) and "Rukhani Zhangyru" (Course towards the future: modernization of Kazakhstan’s identity).

This article provides a comprehensive analysis of sources pertaining to Akkagaz Doszhanova, a highly qualified doctor who emerged from the Kazakh milieu. The author skillfully elucidates Doszhanova's significant contributions to the formation of the healthcare system, her active participation as the first Kazakh female doctor in the political processes of early twentieth-century Kazakhstan, and her collaborative efforts for national interests alongside other "Alash" representatives. Despite her brief life, Doszhanova left an indelible mark on our history.

Annotation

This article discusses the relevance of using virtual and augmented reality in education and medical practice. It explores the importance of these technologies in training future employees and optimizing the activities of medical personnel, drawing insights from foreign examples.

The impact of innovation on enhancing medical education is analyzed, while also considering potential negative effects on the body and perception. The article also aims to assess the prospects for the successful integration of new technologies into modern medical practices and education.

Annotation

  In Kazakhstan, breast cancer remains the leading cause of cancer morbidity and mortality among women. The presented case series aims to summarize cardiovascular events that resulted in discontinuation or suspension of anthracycline-based chemotherapy during an ongoing project on studying the cardiotoxic effects.

  Case 1: Classic acute cardiotoxicity with asystole. Patient Sh., 46 years old, was admitted with a baseline left ventricular ejection fraction (LVEF) of 64% and global longitudinal strain (GLS) of 22.4%. After the first dose of doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2, the patient experienced two episodes of asystole. Trimetazidine was prescribed at a dose of 80 mg. Eventually, Sh. completed the courses of anthracycline therapy after a 1-month delay at a cumulative dose of 455 mg/m2.
  Case 2: Subacute cardiotoxicity with ventricular extrasystole. Patient Zh., aged 47, developed single, paired, and group ventricular extrasystoles after the 2nd course of chemotherapy with doxorubicin 200 mg/m2 (23 days after admission). Carvedilol was prescribed at 25 mg twice daily and Trimetazidine at 80 mg once a day. After one month of monitoring, ventricular extrasystoles disappeared. The patient completed chemotherapy at a cumulative dose of 400 mg/m2, with a 1-month delay.
  Case 3: Severe cardiotoxicity due to pre-existing cardiovascular disease with discontinuation of chemotherapy. Patient M., aged 58, was referred to the very high-risk group for developing atrial fibrillation and heart failure with an LVEF of 51%. M. received Enalapril 5 mg twice daily, Bisoprolol 5 mg, Eplerenone 50 mg, Dapagliflozin 10 mg, and Dabigatran 150 mg twice daily. After three months, anthracycline therapy was canceled at a cumulative dose of 260 mg/m2 due to deterioration of the patient's condition (LVEF 41%).
  Conclusion: Discontinuation or delay of vitally needed chemotherapy in breast cancer patients deteriorates their prognosis for survival. Patients should be constantly monitored during and after anticancer treatment.

Annotation

  Dysbiosis in the intestinal microbiota can arise from various exogenous and endogenous factors. It represents a disruption in the balance of microbial communities within the gut, leading to a reduction or disappearance of beneficial microbes and an increase in opportunistic pathogens.

Given the dynamic nature of modern living conditions, clinicians must consider changes in microbiota composition during diagnostic and treatment procedures. The aim of this study is to analyze the causes and effective methods of diagnosing intestinal dysbiosis through a comprehensive review of the literature.
  Methods
  A literature review of both domestic and foreign sources pertaining to the causes and effective diagnostic methods for intestinal dysbiosis was conducted. Publications were sourced from electronic databases, including PubMed, Google Search, and eLIBRARY, spanning the years 2008 to 2023.
  Results
  Public health is witnessing a significant rise in the prevalence of various noncommunicable diseases (NCDs) globally, such as asthma, food allergies, obesity, celiac disease, diabetes (type 1 and 2), inflammatory bowel disease, autism, Alzheimer's disease, Parkinson's disease, heart disease, and cancer. These conditions often coincide with alterations in the composition, frequency, and abundance of the normal human microbiota. The human microbiota plays a pivotal role in interactions with the environment, metabolism, and regulation of host organism development and physiology. Laboratory methods for diagnosing dysbiosis include both direct (isolation of live microbiota from material) and indirect (determination of microbial activity-related products such as short-chain fatty acids (SCFAs), gas signaling molecules, and enzymes) approaches. These include stool biochemical tests, urine indole and skatole determination, respiratory tests (utilizing hydrogen 14C-glycocholate or 14C with D-xylose), gas-liquid chromatography of fecal or small intestinal fluid, and mass spectrometry.
Conclusion
  Accurate and effective diagnosis of dysbiosis across various biotopes can prioritize microbiome management, enhancing risk assessment, drug discovery and efficacy, prevention, and medical therapy. The optimization of microbiome treatment regimens requires further investigation, including potential adjustments based on life stage, sex, and genetic background of the host. This approach aims to advance sustainable healthcare practices.