ĞYLYM ALIANSY - the center of knowledge and innovation!

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This article explores the international experience of establishing Centers for Best Practices at the primary health care (PHC) level and emphasizes their significance in enhancing organizational effectiveness. The Center for Best Practices serves as a platform for improving efficiency and quality through innovation development,

knowledge sharing, and the implementation of proven approaches within healthcare systems.
The review analyzes successful models of best practice centers from various countries and discusses the potential for adapting these models to the healthcare context of Kazakhstan. Key stages in the creation of such centers, their structural components, and their influence on the professional development of healthcare personnel are examined. The article also highlights the potential challenges in implementing best practice centers and suggests strategies to address them.
This literature review will be of interest to researchers and practitioners in the fields of innovation management, organizational development, and knowledge management within healthcare systems.

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Accurate disease diagnosis is critical for effective treatment and improved medical outcomes.
Purpose. This study aims to assess the concordance between clinical and pathoanatomic diagnoses, identify the causes of discrepancies, and explore ways to enhance diagnostic accuracy and healthcare quality.

Methods. This retrospective, cross-sectional study analyzed autopsy records from 2023. A total of 555 autopsies were reviewed, including 355 adults and 200 children. Clinical diagnoses made prior to death were compared with findings from postmortem examinations. Statistical analysis included descriptive statistics and comparative tests (t-test, ANOVA, χ² test).
Results. Discrepancies between clinical and pathoanatomic diagnoses were observed in 46 cases (8.3%), comprising 25 adult and 21 pediatric cases. Among adults, discrepancies were categorized as follows: errors in diagnosing the underlying disease (52%), diagnostic formulation errors (36%), misclassification of complications (4%), background diseases (4%), and competing diagnoses (4%). Among pediatric cases, the most frequent discrepancies were related to the underlying disease (47%), diagnostic formulation (14%), complications (23%), and competing diagnoses (14%).
Conclusion. The findings indicate that the most common cause of diagnostic discrepancies is errors in identifying the underlying disease. This underscores the need for improved diagnostic protocols and enhanced medical personnel training to reduce misdiagnoses and improve patient outcomes.

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Scientific evidence suggests that SARS-CoV-2 may negatively affect the male reproductive system.
Purpose. This study aimed to examine the main indicators of semen parameters in men who had recovered from COVID-19.

Methods. The study included male patients who had recovered from COVID-19. Between February 2020 and September 2021, semen analysis was conducted on 48 men. Among them, 26 had a confirmed history of COVID-19, verified through laboratory testing (IgG antibodies). Key spermogram indicators were assessed, including ejaculate volume, total sperm count, sperm concentration, percentage of abnormal forms, semen pH, and leukocyte concentration.
Results. The spermogram indicators in patients who recovered from COVID-19 differed significantly from those in men without a history of the infection. The ejaculate volume was reduced by half, and the total sperm count was 3.6 times lower. Sperm concentration decreased by nearly twofold. An increase in semen pH was observed, and the percentage of abnormal sperm forms was twice as high.
Conclusion. Men with a history of COVID-19 and elevated SARS-CoV-2 IgG levels showed significant quantitative and qualitative alterations in semen parameters. These findings suggest that COVID-19 can impair male reproductive function and may contribute to the ongoing global decline in male fertility. This, in turn, could potentially lead to a reduction in birth rates in affected regions.

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Purpose: to conduct a two-stage cluster analysis of clinical and anamnestic data from pediatric patients with different clinical forms of cerebral palsy (CP), along with obstetric and gynecological characteristics of their mothers, to identify pathogenetic phenotypes in children with CP.

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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Forensic medical examinations related to road traffic accidents (RTAs) represent a significant portion of forensic casework in Kazakhstan, accounting for 75–80% of total forensic examinations. The complexity of these examinations imposes a substantial workload on forensic experts and necessitates methodological optimization.

Purpose. This study aims to evaluate forensic medical examination findings concerning injury types in deceased individuals involved in RTAs.
Methods. A retrospective analysis was conducted on forensic medical examination records from the Aktobe Interregional Center for Forensic Examinations in 2023. A total of 2,132 forensic cases were reviewed, with 190 cases specifically related to RTAs selected for analysis.
Results. The study revealed distinct characteristics of injuries sustained inside vehicles, including extensive trauma and a predominance of combined injuries. Passengers were found to sustain more injuries compared to drivers, reflecting the distribution of accident participants. Forensic examinations of RTA-related cases accounted for 15.8% of all forensic medical examinations, with injuries from automobile accidents comprising approximately 80% of traffic-related injuries. The findings also highlighted the high prevalence of multiple and combined injuries, with specific patterns of internal organ damage varying according to the individual’s location within the vehicle.
Conclusion. The frequency, mechanism, and nature of injuries allow for the prediction of injury patterns in RTAs. A comprehensive analysis of RTA-related injuries, alongside comparative forensic studies, can contribute to the refinement of forensic examination methodologies and improve injury classification within forensic practice.

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This article commemorates the 75th anniversary of Professor Bekbolat Zholdin, a distinguished alumnus and long-serving faculty member of Marat Ospanov West Kazakhstan Medical University. Since 1979, he has devoted his career to the university, progressing from assistant and associate professor to Dean of the Faculty of

Physician Training, and ultimately to Head and Professor of the Department of Internal Medicine No. 2.
Professor Zholdin has made substantial contributions to both medicine and medical education. He earned his PhD in Moscow in 1998 and was awarded the academic title of professor in 2007. He played a key role in establishing Kazakhstan’s first regional cardiac surgery center and has actively participated in the leadership of professional medical societies. Over his career, he has trained more than 100 medical residents, fellows, and PhD students. As Principal Investigator, he has led several international studies, including the NCD Risk Factor Collaboration, EUROASPIRE V, and the ESC EORP Heart Failure III Registry. His scholarly output includes more than 300 scientific publications, some of which have appeared in prestigious journals such as The Lancet and Nature. He is ranked among Kazakhstan’s top 1,000 scientists and, in recognition of his outstanding contributions to national science and intellectual development, he was awarded the "Parasat" Order by Presidential Decree in 2023.
Now approaching his 75th birthday, Professor Zholdin remains actively engaged in clinical, educational, and research activities. He continues to conduct daily clinical rounds, mentor residents, master’s and PhD students, and lead the EUROASPIRE VI study on chronic coronary syndrome epidemiology. He is also spearheading the development of heart failure and acute coronary syndrome registries in the West Kazakhstan region. As Director of the Aktobe Branch of the Kazakhstan Society of Cardiologists, he organizes regular master classes and workshops for practicing physicians, leaving a lasting legacy in Kazakhstan’s healthcare and medical education landscape.