Kyrgyz State Medical Academy

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

Research Ethics Committees (RECs) safeguard participants, yet little is known about how their decisions are communicated to study investigators in low- and middle-income countries (LMICs). We analysed 138 decision letters from a public-health REC in Kyrgyzstan (2018-2022) using descriptive statistics and documentary review. REC panel consisted predominantly of clinical and biomedical experts, with identifying data missing for 51% (n = 506/991) of panelists. Lay member participation was absent despite being mandated in SOPs. The first-review approval rate was 55.1%. Communication in decision letters tended to be prescriptive rather than advisory, with critical ethical deficiencies often not flagged. Furthermore, there was a lack of explicit citation of national or international guidance. Our observations point to opportunities to improve transparency, review quality, and stakeholder engagement through standardized templates, targeted reviewer training, and the inclusion of lay members. Strengthening these practices may enhance consistency, quality, and trust in REC decision-making in comparable post-Soviet LMICs contexts.

Amyand's hernia is an uncommon inguinal hernia containing the vermiform appendix. Preoperative diagnosis remains difficult, and many cases are recognized only during surgery. We report a 64-year-old man with a 33-year history of a reducible right inguinal hernia who presented with 5 days of irreducibility, groin pain, fever, and diffuse abdominal pain. Examination showed generalized peritonitis. Ultrasonography demonstrated a fluid-filled right inguinal hernia sac containing a tubular structure, free intraperitoneal fluid, and dilated bowel loops. Emergency inguinal exploration released purulent fluid and revealed the cecum with a gangrenous perforated appendix inside the hernia sac. Because purulent material tracked freely through the internal ring, the procedure was immediately converted to lower midline laparotomy. Appendectomy, abdominal lavage, drainage, and tissue-based hernia repair without mesh were performed. The patient recovered well and was discharged on postoperative day 16.

This review analyzes the human resources of primary health care (PHC). It is part of a series of reviews on various PHC aspects (organizational, management, resources, financing, digitalization, and outcomes. It was compiled to assess the potential for using international experience and evidence-based recommendations to ensure that PHC is provided with trained and efficiently organized human resources in the member states of the Commonwealth of Independent States (CIS). To compile the review, publications (with an emphasis on evidence-based reviews and methodological documents), regulatory documents, and online resources were selected using selected keywords and concepts related to the human resources aspect of PHC and its characteristics, as well as considering the criterion of potential impact on the outcomes of PHC provision. The article presents the results of a review of primary health care personnel in the context of the health system, including the implementation of recommendations for improving human resources with proven effectiveness, selected during the review process, in CIS member states. Particular attention to the potential of primary health care personal to implement the principle of permanence (continuity, succession, consistency) of health care allowed us to systematize the approaches used in the selected CIS countries for its implementation. All the review articles in this series address the transition from a "radar" principle associated with the concept of a "completed case of care" to continuous and ongoing permanent management by a local team of specialists to assist patients in managing their health throughout their lives. This approach allowed to conclude that the permanent provision of primary health care, based on patient cooperation and the use of evidence- based self-care and digital technologies, including telemedicine, helps to address the problem of PHC personnel shortage.

Laparoscopic cholecystectomy is the standard treatment for gallbladder disease; however, the risk of bile duct injury and variability of outcomes persist. Objective. To evaluate contemporary safety standards in cholecystectomy – clinical algorithms and technological drivers – in the context of preventing bile duct injuries and improving technical reproducibility. Materials and methods. A narrative review of publications from 2015–2025 was conducted (PubMed/MEDLINE, Scopus, Web of Science). Systematic reviews, meta-analyses, clinical and registry studies, and consensus recommendations were analyzed. The evidence was structured by key domains: safety, imaging, artificial intelligence, alternative technologies, and ERAS pathways. Results. The Critical View of Safety remains central to bile duct injury prevention, supported by fluorescent cholangiography and digital quality control. Artificial intelligence reduces technical variability. Conclusion. Current standards in cholecystectomy are evolving toward technologically supported and standardized surgical care, enhancing safety and quality of treatment.