Yassawi Journal of Health Sciences

DIAGNOSTIC VALUE OF TRICHOSCOPY IN THE DIFFERENTIAL DIAGNOSIS OF VARIOUS FORMS OF ALOPECIA

A Оспанова — 2025-12-23

Alopecias of various origins present a significant diagnostic challenge in dermatological practice. Trichoscopy, a non-invasive method for visualizing the scalp, has become a key tool in recent years for the early and accurate diagnosis of hair loss.

Objective. To determine the modern capabilities of trichoscopy in the differential diagnosis of various forms of alopecia and to assess its diagnostic value.

Materials and Methods. An analytical review of 28 publications from 2019–2025 was conducted, including original studies and meta-analyses on trichoscopic diagnostic criteria in alopecias. Key morphological features, their sensitivity and specificity, as well as the role of the method in monitoring treatment effectiveness were analyzed.

Results. It was established that in androgenetic alopecia the most informative features are hair shaft diameter variability and the perifollicular halo; in alopecia areata - yellow and black dots, “exclamation mark” hairs; in scarring forms - absence of follicular openings and vascular changes. According to systematic reviews, the average diagnostic accuracy of trichoscopy is 90–95%. New digital technologies and artificial intelligence enhance the objectivity and reproducibility of interpretation.

Conclusions. Trichoscopy is an essential component in the diagnosis of alopecias, allowing differentiation of their forms, determination of disease activity, and assessment of treatment effectiveness. Standardization of terminology and the development of digital platforms will create new opportunities for integrating the method into clinical practice.

RADIOGRAPHY OF THE HIP JOINTS IN INFANTS: RADIATION EXPOSURE, IMPACT ON THE REPRODUCTIVE SYSTEM, AND PROTECTIVE MEASURES

N Shapambayev — 2025-12-23

Developmental dysplasia of the hip (DDH) occurs in 2–4% of newborns and requires early diagnosis to prevent complications. Radiography remains the primary imaging method for evaluating the hip joint in infants. Even low-dose ionizing radiation raises concerns regarding potential effects on the reproductive organs [1] The aim of this study was to assess the impact of hip radiographic examinations on the reproductive organs of children under one year of age and to analyze the use of protective aprons in city clinics of Shymkent, Kazakhstan.

Data collection and analysis were performed using the Akgun PACS Viewer software, which allowed systematic evaluation of radiographic images and compliance with radiation protection measures. Dosimetric assessment was conducted based on exposure parameters recorded by the system to calculate the absorbed dose to the gonads. Statistical analysis was applied to determine the frequency of protective apron use and to evaluate the potential risk of radiation exposure to reproductive organs [2]

The study analyzed 223 radiographic images of 87 infants from 5 major city clinics. Results showed that approximately 70% of infants underwent up to three hip radiographs in the first year of life, while protective aprons were used in only 60% of cases. Dosimetric analysis indicated that without protection, the testes and ovaries received doses exceeding recommended limits, whereas correct use of lead aprons and shields reduced the absorbed dose by approximately tenfold.

The relevance of this study is supported by the need to enforce the Ministry of Health of the Republic of Kazakhstan Order No. KR DSM-275/2020 (December 15, 2020) on sanitary and epidemiological requirements for radiation safety, which mandates the use of protective aprons for children during hip radiography.

The findings emphasize the necessity of strict adherence to radiation safety protocols and support the regulatory requirement for mandatory use of protective aprons and shields during infant hip radiography [3, 14]

ENDOLYMPHATIC ANTIBIOTIC THERAPY IN PATIENTS WITH RECURRENT UROGENITAL DISEASES RESISTANT TO TRADITIONAL ANTIBIOTIC THERAPY: A LITERATURE REVIEW

B Aitbaiuly — 2025-12-23

Endolymphatic and lymphotropic therapies have recently been applied across various medical fields, including acute surgical abdominal conditions, urology, gynecology, traumatology, phthisiology, and oncology. These therapies are used for both prevention and treatment of complications in urogenital diseases.

Objective: To review the literature on the efficacy of endolymphatic antibiotic therapy in men with recurrent urogenital diseases resistant to conventional antibiotic treatment.

Materials and methods: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, Medline, and Wiley Online Library for publications from 2015 to 2025. Fifty full-text, English-language articles were selected based on inclusion criteria: open access, high methodological quality, and relevance. Studies of low quality, conference abstracts, and articles without full-text access were excluded.

Results and Conclusions: Endolymphatic antibiotic administration is recommended as a primary treatment for men with acute inflammatory urogenital diseases. Literature analysis shows broad applications of endolymphatic and lymphotropic therapies in surgery, urology, gynecology, traumatology, phthisiology, oncology. Further research is needed to optimize drug selection, dosage, and administration schedules. Enhancing immune function through lymphological methods appears promising.

ASSESSMENT OF THE IMPACT OF SOCIO-DEMOGRAPHIC FACTORS ON QUALITY OF LIFE IN PATIENTS WITH COEXISTING ARTERIAL HYPERTENSION AND ABDOMINAL OBESITY

N.A. Kudaybergen — 2025-12-30

A comprehensive approach to the management of arterial hypertension and abdominal obesity should include both pharmacological therapy and psychosocial support. Educational programs aimed at informing patients about the severity of the disease and the necessity of adhering to all medical recommendations play a crucial role. Improving quality of life and enhancing patient adherence to treatment require comprehensive and individualized interventions
Objective: To assess the influence of socio-demographic and behavioral factors on health-related quality of life (HRQoL) in patients with coexisting arterial hypertension and abdominal obesity.
Material and Methods: A cross-sectional study included 101 patients (mean age 54.5 ± 1.02 years; 19 men, 82 women) registered at the Clinical-Diagnostic Center of Khoja Akhmet Yassawi International Kazakh-Turkish University. Inclusion criteria were adults aged ≥18 years with physician-diagnosed arterial hypertension (≥140/90 mmHg) and abdominal obesity (waist circumference ≥102 cm for men, ≥88 cm for women). Anthropometric measurements, blood pressure, and HRQoL were assessed using the SF-36 questionnaire. Data were analyzed using descriptive statistics, Mann–Whitney U, and Kruskal–Wallis tests in SPSS 29.0.
Results: Women had lower scores than men in Role Physical (RP) and Role Emotional (RE) domains. Married participants showed reduced scores in General Health (GH), Vitality (VT), Social Functioning (SF), and Mental Health (MH). No significant differences were observed regarding educational level or occupation. Behavioral factors, including low physical activity and smoking, were associated with lower HRQoL in specific domains.
Conclusion: Socio-demographic and behavioral factors significantly impact HRQoL in patients with coexisting hypertension and abdominal obesity. Women and married individuals demonstrated lower quality-of-life scores in several physical and mental health domains, emphasizing the importance of targeted lifestyle and psychosocial interventions.

CHARACTERISTICS OF POST-COVID SYNDROME IN CHILDREN

М. Temirova — 2025-12-30

This article presents information on the neurological features of children in the post-COVID period. Post-COVID syndrome (PCS) is a symptom complex that occurs during and after COVID-19, lasting more than 12 weeks, and is not the result of another disease. Clinical manifestations of PCS are diverse, and under their mask, either the debut or exacerbation of chronic organic pathology triggered by the virus may be hidden. PCS is a diagnosis of exclusion. The main manifestations of PCS include: autonomic dysregulation, cognitive and psycho-emotional disorders, and impairments of the respiratory, cardiovascular, and digestive systems. The direct pathogenetic factors of the main neurological manifestations of PCS are persistent cerebral hypoperfusion, hypoxia, and hypoxemia, which lead to energy deficits in neuronal structures, metabolic disturbances, as well as virus-induced structural damage to cortical neurons and subcortical structures of the brain.

THE STATE OF ANTIBIOTIC USE AT SHYMKENT CITY CLINICAL HOSPITAL 1

T.N Ormanov — 2025-12-30

In medical practice, monitoring the effectiveness of antibiotics and the susceptibility of pathogens plays an important role. According to the recommendations of the World Health Organization, controlling the efficacy and safety of antibacterial therapy can reduce infection resistance. Studying the patterns of antibiotic use in a hospital that provides emergency and planned specialized medical care is of both scientific and practical interest.
Aim of the study: To examine cases of antibacterial therapy prescriptions in the clinic and to assess the state of antibacterial therapy based on the results of a cross-sectional (point-prevalence) study.
Materials and methods: The study of antibacterial prescriptions was conducted in the clinical departments of City Clinical Hospital No. 1 in Shymkent. All medical records of patients receiving treatment at the time of the study were analyzed. A cross-sectional epidemiological method was used to assess the effectiveness of antibacterial therapy.
Results and conclusions: The prevalence of antibacterial therapy in the hospital in our study was 91.9%. Most patients (75%) received one antibiotic during treatment. The proportion of patients who were prescribed two antibacterial drugs was 17.6% of all patients receiving antibacterial therapy, while the combined proportion of those prescribed three or more antibiotics was 7.4%. Cephalosporins were used as initial antibacterial therapy in 81% of cases, and in 72.0% of these cases the effectiveness of the drugs was sufficient. Cefazolin and Ceftriaxone, which were used as the main antibiotics in postoperative patients, demonstrated effectiveness rates of 81% and 66.4%, respectively. The low effectiveness of ceftriaxone observed in our study highlights the need for enhanced monitoring of this antibiotic.

MANAGING INCENTIVE PAYMENTS IN PRIMARY HEALTH CARE: BUSINESS SOLUTIONS FOR SUSTAINABLE HEALTHCARE DEVELOPMENT

B.B Toymetov — 2025-12-30

This study examines incentive payment schemes in primary care and their impact on healthcare effectiveness and equity. We analyze four principal remuneration models: Fee-for-Service, Capitation Financing, Pay-for-Performance (P4P), and hybrid approaches.
Kazakhstan introduced capitation financing with P4P elements in 2009. Our analysis identifies three fundamental paradoxes in this system. First, weak risk-adjustment mechanisms chronically underfund facilities serving vulnerable populations. Second, payment delays undermine financing predictability and create financial instability. Third, incentives for selective patient enrollment contradict universal health coverage goals. The P4P component shows additional weaknesses: questionable quality indicators, inadequate outcome attribution, and poor integration across care levels.
Based on international experience (Kyrgyzstan, Uzbekistan, United States), we propose four optimization strategies: strengthening risk-adjustment models; refining P4P mechanisms with emphasis on equity and provider support; eliminating payment delays; and developing comprehensive motivation frameworks that combine adequate base salaries and fair capitation rates with non-financial incentives such as professional development and improved working conditions.
Our findings show that financial mechanisms without broader systemic support generate counterproductive incentives. These results inform remuneration policy development, primary care quality improvement, and healthcare expenditure optimization.