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Tympanosclerosis is a chronic condition often associated with otitis media, necessitating precise classification to guide effective treatment. This study aims to analyze existing classifications of tympanosclerosis and propose a practical modification to streamline treatment planning.

Purpose: to analyze existing classifications of tympanosclerosis and propose a unified, practical classification system for optimizing treatment strategies.
Methods. A retrospective analysis was conducted on the case histories of 403 patients diagnosed with chronic otitis media between 2016 and 2022. All patients underwent microscopic otoscopy and computed tomography of the temporal bone. Tympanosclerosis was diagnosed in 166 patients, all of whom underwent surgical intervention to restore tympanic membrane integrity and remove tympanosclerotic plaques.
Results. A modified classification system for tympanosclerosis was developed to enhance treatment planning and reduce unforeseen complications:• Grade I: Tympanosclerotic changes confined to the eardrum without hearing impairment.• Grade II: Tympanosclerotic changes involving the eardrum and auditory ossicles, with conductive or mixed hearing loss and a bone-air gap of up to 15 dB.• Grade III: Tympanosclerotic changes affecting the eardrum, ossicles, and tympanic cavity, with conductive hearing loss and a bone-air gap of up to 30 dB.• Grade IV: Extensive tympanosclerosis involving the eardrum and ossicles, with conductive or mixed hearing loss and a bone-air gap exceeding 30 dB.
Conclusion. The proposed modified classification provides practical utility by integrating the localization and severity of tympanosclerotic changes with hearing status. By combining visualization and instrumental diagnostic data, this system enables precise determination of disease extent and facilitates tailored treatment planning for optimal outcomes.

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The development of primary healthcare (PHC) includes establishing emergency medical care units within polyclinics to address less urgent medical situations effectively. When calls are received at the ambulance station, dispatchers categorize them into four urgency levels.

The fourth category, encompassing acute conditions and exacerbations of chronic diseases without immediate life-threatening risks, is managed by polyclinic emergency departments.
Purpose: to analyze the organization and performance of emergency medical care at the PHC level in Aktobe.
Methods. A retrospective analysis was conducted on the emergency medical service operations at City Polyclinic No. 1 in Aktobe from 2019 to 2023.
Results. The number of fourth-category calls increased annually, from 15,231 in 2019 to 19,183 in 2023, reflecting a 1.2-fold rise. Delayed calls also surged from 412 in 2019 to 1,146 in 2023, a 2.7-fold increase. However, hospitalizations decreased by 17.4%, from 1,953 in 2019 to 1,614 in 2023. Respiratory diseases accounted for the highest number of calls (5,008), followed by circulatory system diseases (3,818), digestive system diseases (2,609), and nervous system diseases (1,353). Adults over 18 years constituted approximately 68% of the total calls. Most calls occurred during the polyclinic's working hours, emphasizing the need for optimal resource allocation during these times.

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Cervical cancer is the most common genital neoplasm in women and remains a significant public health concern globally. Despite its visual localization, advanced-stage (III-IV) cervical cancer is diagnosed in 39.8% of patients.

Cervical cancer ranks among the most commonly diagnosed cancers worldwide, alongside breast cancer, which is second in frequency and third in mortality among cancers affecting women.
Purpose: to enhance the effectiveness of cytological diagnostics in cervical cancer screening, aiming to identify precancerous changes and reduce morbidity and mortality risks.
Methods. A retrospective analysis was conducted on cervical smears from women aged 30–70 in the Aktobe region, screened using liquid cytology for cervical cancer. The study included 27,163 women in 2021, 29,205 in 2022, 27,396 in 2023, and 25,819 in the first nine months of 2024.
Results. From 2021 to 2024, a total of 4,359 women showed cytological abnormalities. Among them, atypical squamous cells of undetermined significance (ASC-US) were detected in 144 cases (3.3%), mild dysplasia in 252 cases (5.7%), severe dysplasia in 167 cases (3.8%), suspected cancer in 40 cases (0.9%), and confirmed cancer in 8 cases (0.2%). The data revealed that pathological changes were more prevalent in urban women compared to rural women, with precancerous cervical changes occurring nearly twice as often in urban populations.
Conclusion. Cytological screening using liquid cytology effectively identifies precancerous changes and cervical cancer. Urban women demonstrated a higher prevalence of pathological processes, underscoring the need for targeted interventions to address regional disparities in cervical cancer screening outcomes.

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Purpose: to assess the effectiveness of invasive methods of prenatal diagnostics in identifying chromosomal pathologies of the fetus in pregnant women of the Aktobe region.

Methods: A retrospective analysis was conducted on data from the Aktobe Regional Perinatal Center for 2023, covering prenatal screening results from the first trimester of 43,584 pregnant women. This represented 82.5% of those registered for prenatal care before 12 weeks of gestation. The Life Cycle computer program was utilized to calculate individual risk of chromosomal abnormalities. As a result, a high-risk group of 3,343 women (7.7%) was identified, and the course and outcomes of their pregnancies were further analyzed. Following informed consent, invasive prenatal diagnostic procedures were performed on 845 (25.3%) women in this group, including chorionic villus sampling (4.8%), placentocentesis (23.4%), amniocentesis (38.2%), and cordocentesis (33.5%).
Results: Cytogenetic and molecular genetic studies confirmed fetal chromosomal abnormalities in 82 cases (10.2%) among those who underwent invasive procedures. The following syndromes were identified: Down syndrome (69.7%), Edwards syndrome (17.4%), Patau syndrome (3.5%), Turner syndrome (4.6%), and structural rearrangements (4.6%). Among the 2,498 women at high risk who declined invasive diagnostics, adverse pregnancy outcomes were observed in 39 cases (1.6%).
Conclusion: The retrospective analysis underscores the importance of timely assessment of second-trimester markers, including echographic and biochemical indicators, for early detection of chromosomal abnormalities. Adherence to prenatal diagnostic protocols facilitates timely identification of chromosomal abnormalities, allowing families to make informed decisions about pregnancy continuation.

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Radiofrequency ablation (RFA) is a widely recognized, effective, and minimally invasive procedure for the radical treatment of paroxysmal tachycardia. However, rare complications, such as myocardial infarction (MI), can occur post-procedure.

Purpose: to report a clinical case of MI following RFA in a patient with Wolff-Parkinson-White (WPW) syndrome and to analyze potential mechanisms and preventive measures.
Methods. A 32-year-old male patient presented with frequent palpitations. Electrophysiological study revealed an accessory pathway with right inferior paraseptal localization. The patient underwent RFA, after which he experienced angina-like chest pain with ST-segment elevation on ECG and elevated troponin levels. Coronary angiography showed 60–65% stenosis in the distal third of the right coronary artery (RCA), with no significant lesions in other coronary arteries. The patient was managed conservatively and discharged in satisfactory condition after 7 days. A literature review was conducted using PubMed, Google Scholar, Web of Science, Scopus, and RSCI databases with keywords: "WPW syndrome," "radiofrequency ablation," and "myocardial infarction."
Results. The incidence of MI following RFA is reported between 0.06% and 0.1%. Suggested mechanisms include coronary artery spasm, thermal injury to the coronary endothelium leading to acute or subacute thrombosis, and prolonged high-energy exposure near the coronary sinus. The risk of coronary artery injury is particularly high when the distance between the ablation site and the coronary artery is ≤2 mm, increasing the probability of damage to 50%.
Conclusions. MI after RFA is more likely during procedures near the coronary sinus. Preventive strategies include detailed arrhythmia mapping, careful ablation technique, and experienced operators. In cases of coronary artery injury, timely percutaneous coronary intervention is critical for favorable outcomes.

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Parkinson's disease (PD) is the second most common neurodegenerative disorder worldwide, with an annual incidence of 8–18 per 100,000 individuals. Its prevalence rises significantly in populations aged 60 and older, with cases projected to double by 2030.

While amantadine is well-recognized for managing dyskinesia and as initial monotherapy in PD, its utility in addressing PD decompensation remains insufficiently studied.This report details the case of a 72-year-old Asian woman with PD who developed bilateral lower lobe pneumonia with a prolonged fever. Her condition was marked by worsening motor symptoms, including increased rigidity and tremors. An intravenous infusion of amantadine sulfate was administered, resulting in notable improvements in muscle tone, rigidity, and tremor control. This case highlights the potential role of amantadine in stabilizing motor function during acute systemic stress, such as severe infections.The findings suggest that amantadine sulfate may serve as an effective therapeutic option for PD decompensation in complex clinical scenarios involving comorbid conditions. This case underscores the need for further investigation to define the therapeutic range and establish targeted treatment protocols for PD patients requiring critical care interventions.

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Medical education in Kazakhstan is undergoing significant transformation, driven by the integration of innovative teaching and learning methodologies. Among these, digital and simulation technologies have emerged as essential components in modern medical training.

Simulation-based learning, which involves modeling clinical cases, plays a pivotal role in developing essential medical competencies. Effective implementation of high-quality simulation training requires advanced technical equipment in practical skills centers, comprehensive training for instructors and educators, and a robust repository of clinical scenarios across diverse medical disciplines. The success of simulation training is rooted in a systematic learning trajectory that follows the principle of "from simple to complex," aligning with students' educational levels. This begins with the technical refinement of basic practical skills and progresses to interdisciplinary approaches for addressing complex simulated clinical situations. Such structured learning ensures that medical graduates possess the necessary knowledge and practical expertise to meet professional demands upon completing their education.

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This study examines the life, scientific contributions, and pedagogical legacy of Academician Turakbai Zhetenovich Umbetov (1938–2024), a prominent Kazakh scientist and educator in the fields of anatomy, histology, cytology, and embryology.

As a distinguished representative of morphological science in Kazakhstan, Umbetov exemplified the intellectual and patriotic spirit of the Kazakh people. His work significantly advanced the understanding of morphological sciences and higher medical education in the Republic of Kazakhstan.Umbetov's scientific research addressed a broad spectrum of fundamental and applied topics, including the histophysiology of lymphoid organs, adaptive and reactive transformations of organs to adverse environmental factors, and innovative teaching methods in morphology. His contributions in lymphology and immunomorphology gained recognition both in Kazakhstan and internationally. Umbetov's ecological-morphological studies elucidated the structural and functional transformations in humans and vertebrates exposed to extreme environmental conditions, such as heavy metal toxicity and industrial pollutants. These findings provided a scientific foundation for developing therapeutic and preventive measures to improve occupational health.Moreover, his textbooks on anatomy, histology, cytology, and embryology serve as encyclopedic resources, offering comprehensive and modern perspectives on morphological science. Turakbai Umbetov's legacy continues to shape the fields of anatomy and medical education in Kazakhstan and beyond.