Background/Aim of Study: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality globally. Cardiac rehabilitation (CR) plays a pivotal role in the recovery of post-acute myocardial infarction (AMI) patients. Despite evidence supporting its clinical benefits, CR remains underutilized, especially in middle-income countries like Kazakhstan. This study aimed to evaluate the clinical effectiveness and economic impact of phase II CR among patients with AMI treated at the Almaty City Cardiology Center between 2018 and 2022. Methods: A retrospective cohort study was conducted using data from 2672 AMI patients. Two cohorts were compared: those who participated in phase II CR and those who did not. Primary outcomes included changes in left ventricular ejection fraction (LVEF), rehospitalization rates, and return to active work. Results: Economic outcomes involved direct medical costs related to initial hospitalization and follow-up care. CR participants showed significant improvements in LVEF (53.7% vs. 49.0% in non-CR patients, p < 0.001). Despite these clinical benefits, there was no significant reduction in long-term treatment costs between the CR and non-CR groups. CR users had slightly higher initial treatment costs but similar cumulative costs for subsequent treatments over two years. Importantly, government funding limitations were found to hinder the full effectiveness of CR programs in Kazakhstan. Conclusions: Phase II CR improves cardiac function in AMI patients but does not reduce long-term treatment costs. The current insufficient government funding for CR limits its broader impact. Expanding CR services and increasing funding are essential to maximize its benefits within Kazakhstan’s healthcare system.

Background: Patient-centered care is particularly important in assisted reproductive technology, where treatment is clinically demanding and emotionally intensive. This study documented a preliminary cultural and linguistic adaptation of a fertility-care survey for Kazakhstan and evaluated patient–staff perception gaps, item-level priorities, preliminary reliability, and exploratory associations with global care ratings. Methods: A cross-sectional survey was conducted in two assisted-reproduction clinics in Almaty. The analytic workbook contained 273 patient and 74 staff records; 173 patient response patterns were unique and 100 records matched an earlier exact pattern. Group-level patient–staff comparisons between independent respondent samples used prespecified harmonized indices, Welch tests, false-discovery-rate correction, clinic-stratified analyses, and one-pattern-per-record sensitivity analyses. Importance–experience differences were calculated within respondents with both values available. Global-rating regressions used HC3 robust inference and were treated as exploratory. Results: Staff rated cost, attitude and communication, information and education, and participation more favorably, whereas patients rated privacy, emotional support, and continuity more favorably. Accessibility and competence showed little difference. Clinic-stratified and one-pattern-per-record analyses preserved the principal contrast directions, although the Physical Comfort proxy was not robust. Several indices showed weak or negative internal consistency. Global ratings had a marked ceiling, with 79.1% at 10/10, and the HC3 joint test for the added care-index block was not significant (p = 0.080). Conclusions: This exploratory survey identified substantial, bidirectional group-level patient–staff differences and concrete item-level priorities, but the scoring and psychometric evidence are insufficient to interpret the domain indices as established measurement scales. Source-codebook verification and broader structural validation are required.

Objective This study provides a comprehensive bibliometric review of patientcentered care (PCC) in in vitro fertilization (IVF), a domain integral to improving patient outcomes, satisfaction, and experiences in assisted reproductive technology. By analyzing global research output and trends, this study aims to identify key themes, contributors, and gaps in the literature to inform future research and practice. Methods Data were collected from Scopus and Web of Science databases, covering the period from 2003 to 2024. Bibliometric analyses, conducted using R Studio and Biblioshiny, examined publication trends, keyword frequencies, and collaborative networks among authors, institutions, and countries. A supplementary literature review contextualized bibliometric findings to address limitations in metadata. Results A total of 54 studies from 33 unique sources were analyzed, revealing an annual growth rate of 11.57% in PCC publications up to 2023. The USA and the Netherlands led in research output, contributing 22 and 16 publications, respectively. Mayo Clinic and prominent authors such as Nelen W. and Kremer J. were key contributors. Keywords like “infertility,” “in vitro fertilization,” and “patient care” demonstrated increasing prominence, underscoring growing interest in PCC. Barriers to PCC were identified at institutional, communication, environmental, and personal levels, while facilitators included multidisciplinary approaches and technological integration. Conclusion This review highlights PCC’s critical role in enhancing IVF outcomes and identifies gaps in psychological support, clinicianpatient communication, and access equity. Recommendations include targeted interventions, international collaborations, and integration of personalized care models. Future research should explore innovative strategies to overcome barriers and advance PCC frameworks in fertility care. BJMS, Vol. 24 No. 04 October’25 Page : 1093-1105

Background: Advanced endovascular procedures are increasingly used for ischemic stroke, but real-world evidence from middle-income settings remains limited, particularly regarding survival, disability, and neurorehabilitation. This study examined mortality, recorded disability, procedure-related differences, and neurorehabilitation exposure among patients receiving high-technology stroke care in Almaty, Kazakhstan. Methods: We conducted a retrospective cohort study of 328 adults with ischemic stroke who underwent endovascular or stent-based procedures between 2014 and 2024. Survival was assessed using Kaplan–Meier analysis and Cox proportional-hazards regression. Binary mortality status and recorded disability were examined using logistic regression. Procedure codes were grouped as mechanical thrombectomy/endovascular removal, intracranial stenting, and embolization/coiling/other procedures. Results: Neurorehabilitation was received by 39% of patients and was associated with better crude survival (1 year survival 93.6% vs. 76.7%; 5-year survival 69.0% vs. 60.7%; log-rank p = 0.001). In the adjusted Cox model, older age (HR = 1.069, 95% CI 1.046–1.092, p < 0.001) and greater total bed-day burden (HR = 1.071, 95% CI 1.029–1.116, p = 0.001) were associated with higher mortality hazard. Binary neurorehabilitation was not independently associated with survival (p = 0.803). Male sex was the only consistent factor associated with recorded disability (fully adjusted OR = 2.662, 95% CI 1.261–5.617, p = 0.010). Conclusions: Older age and bed-day burden were the most stable mortality-related factors. Neurorehabilitation was linked to better crude survival but not adjusted survival or recorded disability. Procedure-related and disability findings should be considered exploratory because baseline stroke severity and validated functional scales were unavailable.