Kazakh National Medical University is a university in Almaty, Kazakhstan. It was established in 1931, and the first rector was S.D. Asfendiyarov. In 2001, the government classified it as a "national" university.The university has a student population of 11,000 students and PhD students study at KazNMU, and 1500 faculty members.
The study is devoted to the systematic analysis of urological and andrological morbidity among the male population in selected European (Germany, France, Italy, Poland) and Turkic countries (Turkey, Kazakhstan, Azerbaijan) with a focus on assessing the role of laboratory diagnostics in the early detection, monitoring, and prediction of clinical forms of pathology. The purpose of the study is to establish a link between the prevalence of urological diseases and the level of development of laboratory infrastructure and to determine the effectiveness of routine, biochemical and molecular genetic methods. The methodological framework includes a content analysis of data from the European Association of Urology, the World Health Organisation, National urological registries, and laboratory reports, an epidemiological analysis of morbidity among men over 50 years of age, and a comparative assessment of the diagnostic capabilities of the public and private sectors. Higher prevalence rates of benign prostatic hyperplasia (BPH) (up to 42.5
Hemispherotomy is an effective surgical option for children with drug-resistant epilepsy originating from a single hemisphere. This paper details the first experience using a navigated augmented reality (AR) system to guide a vertical parasagittal hemispherotomy by Delalande. Twelve consecutive patients with a median age of 6.5 years (range 1 to 17 years) underwent the procedure between 2022 and 2023. The patient pathologies included Rasmussen encephalitis, congenital cortical malformations, post-stroke epilepsy, post-inflammatory changes, and Sturge-Weber syndrome, Two of the patients had previously undergone an incomplete disconnection surgery elsewhere. The preoperative evaluation included clinical examinations, video EEG monitoring, and MRI scans. All surgeries used AR guidance in the microscopes field of view established by the neuronavigation system (Brainlab, Germany). Intraoperative AR guidance enhanced the visualization of anatomical structures, which was particularly helpful in cases of congenital malformations where pathological brain tissue narrowed the surgical corridor. Two patients (16.7
BACKGROUND:Patients with noncardioembolic ischemic stroke or transient ischemic attack (TIA) are at risk for recurrent stroke. Low factor XI levels are associated with a reduced risk of ischemic stroke. Asundexian inhibits activated factor XI. Whether the addition of asundexian to antiplatelet therapy would be superior to antiplatelet therapy alone for the secondary prevention of ischemic stroke is unclear. METHODS:In this phase 3, double-blind trial, we randomly assigned patients within 72 hours after the onset of a noncardioembolic ischemic stroke or high-risk TIA to receive asundexian (50 mg once daily) or placebo, in addition to planned dual or single antiplatelet therapy. Patients had at least one of the following: a nonlacunar infarct on imaging, a history of atherosclerosis, or evidence of atherosclerotic plaque at any location on cerebrovascular imaging. The primary efficacy outcome was ischemic stroke. The composite of death from cardiovascular causes, myocardial infarction, or stroke was a key secondary outcome. The primary safety outcome was major bleeding. RESULTS:Among 12,327 patients who underwent randomization (6162 to the asundexian group and 6165 to the placebo group), the incidence of ischemic stroke was lower in the asundexian group than in the placebo group (6.2% vs. 8.4%; cause-specific hazard ratio, 0.74; 95% confidence interval [CI], 0.65 to 0.84; P<0.001). The incidence of the composite of death from cardiovascular causes, myocardial infarction, or stroke was lower in the asundexian group than in the placebo group. The incidence of major bleeding was similar in the asundexian group and the placebo group (1.9% and 1.7%, respectively; cause-specific hazard ratio, 1.10; 95% CI, 0.85 to 1.44). The incidence of adverse events was 69.3% in the asundexian group and 70.1% in the placebo group; the incidence of serious adverse events was 19.2% and 19.5%, respectively. CONCLUSIONS:Among patients with noncardioembolic ischemic stroke or high-risk TIA treated with antiplatelet therapy, asundexian at a daily dose of 50 mg resulted in lower risks of ischemic stroke and major cardiovascular events than placebo, without a higher risk of major bleeding. (Funded by Bayer; OCEANIC-STROKE ClinicalTrials.gov number, NCT05686070.).
BACKGROUND AND IMPORTANCE:Microsurgical DREZotomy (MDT) involves lesioning the dorsal root entry zone at the cervical spinal level, carrying a potential risk of iatrogenic spinal cord injury. Misidentifying the C4 root can lead to impaired diaphragmatic contractions and respiratory compromise. This report is the first MDT procedure in our Central Asian region and introduces the simultaneous analysis of 3 ventilator waveforms-capnography, pressure time, and flow time-as a novel, rapid-response intraoperative neurophysiological monitoring for definitive C4 root identification. CLINICAL PRESENTATION:Traumatic brachial plexus avulsion is an upper limb injury resulting in severe complications such as paralysis and neuropathic pain. Patients with refractory, pharmaco-resistant pain may be candidates for cervical MDT. Intraoperative neurophysiological monitoring during MDT is beneficial because it allows for anatomical mapping from C4 to Th1 nerve roots. The C4 root should not be targeted during MDT because it is cardinal for diaphragmatic muscular activity. Three ventilation curves simultaneously displayed synchronous changes during C4 ventral root stimulation, indicative of phrenic excitation and the diaphragm's reaction against the anesthesia machine. The expected C4 ventral root responses completely aligned with the stimulation patterns observed across all 3 monitored parameters. CONCLUSION:The simplicity of this method and its high practical applicability make it valuable for identifying phrenic nerve fibers during various surgical procedures where nerve roots responsible for diaphragmatic muscle contraction may be at risk.
Gestational weight gain may affect the health of a woman and her child in the short and long term. Both inadequate and excessive weight gain are associated with several adverse pregnancy and delivery outcomes for the mother and fetus. However, optimal ranges of weight gain during pregnancy remain unclear and insufficiently studied for all categories of pregestational body mass index. This review aimed to examine the relationship between ranges of gestational weight gain and the risk of adverse maternal and fetal outcomes. It also aimed to assess the specific features of gestational weight gain based on pregestational body mass index and which strategies can optimize it. The source search was conducted in eLibrary.Ru, PubMed, Medline, Crossref, and Google Scholar databases from 2009 to 2025 using the following keywords: “гестационная прибавка веса” (gestational weight gain), “осложнения беременности” (pregnancy complications), “ожирение” (obesity), “гестационный сахарный диабет” (gestational diabetes mellitus), and “макросомия” (macrosomia). Preference was given to data from randomized controlled trials, systematic reviews, and meta-analyses. Pregestational body mass index is a crucial predictor of favorable pregnancy outcomes. Therefore, it should be considered the primary target for preventing pregnancy and delivery complications associated with excessive body weight and obesity. Inadequate and excessive gestational weight gain are linked to an increased risk of adverse pregnancy and delivery outcomes for the mother (e.g., gestational hypertension, gestational diabetes mellitus, preterm birth, complicated labor, and increased risk of cesarean section) and fetus (e.g., growth disorders, prematurity, and birth trauma). Currently, no unified protocol exists for managing patients with weight changes during preconception care and pregnancy. This is further complicated by regional factors (e.g., place of residence, dietary traditions, and cultural differences) and individual factors (e.g., influence of the immediate social environment, constitutional characteristics, and childhood and adolescent conditions). Population-level studies examining the causes and consequences of variations in gestational weight gain should be continued as they are critical for decreasing maternal and perinatal morbidity and mortality.
