Recurrent pregnancy loss is a complex health challenge with no universally accepted definition. Inconsistency in definitions involves not only the number of spontaneous abortions (two or three) that are accepted for recurrent pregnancy loss but the types of pregnancy and gestational age at miscarriage. Due to the heterogeneity of definitions and criteria applied by international guidelines for recurrent pregnancy loss, the true incidence of recurrent miscarriage, which is reported to range from 1% to 5%, is difficult to estimate. Moreover, the exact etiology of recurrent pregnancy loss remains questionable; thus, it is considered a polyetiological and multifactorial condition with many modifiable and non-modifiable factors involved. Even after thoroughly evaluating recurrent pregnancy loss etiology and risk factors, up to 75% of cases remain unexplained. This review aimed to summarize and critically analyze accumulated knowledge on the etiology, risk factors, relevant diagnostic options, and management approach to recurrent pregnancy loss. The relevance of various factors and their proposed roles in recurrent pregnancy loss pathogenesis remains a matter of discussion. The diagnostic approach and the management largely depend on the etiology and risk factors taken into consideration by a healthcare professional as a cause of recurrent miscarriage for a particular woman or couple. Underestimation of social and health consequences of recurrent pregnancy loss leads to compromised reproductive health and psychological well-being of women after miscarriage. Studies on etiology and risk factors for recurrent pregnancy loss, especially idiopathic, should be continued. The existing international guidelines require updates to assist clinical practice.

Postpartum depression (PPD) is a severe mental health condition that affects women following childbirth and is marked by persistent sadness, anxiety, fatigue, and difficulty functioning. Unlike the temporary “baby blues”, PPD is more severe and long-lasting, potentially leading to negative consequences for mother and child. Globally, PPD impacts approximately 10–20% of postpartum women, with prevalence influenced by genetic, hormonal, psychological, and socio-environmental factors. Early detection is crucial, with screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) commonly used in clinical practice. Treatment options include pharmacological interventions such as selective serotonin reuptake inhibitors (SSRIs), psychological therapies like cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), and lifestyle modifications. Despite the growing awareness of PPD, stigma remains a significant barrier to treatment, discouraging many women from seeking help. In low-income countries, where mental health care is often underfunded, accessing professionals trained in perinatal mental health presents an even greater challenge. This gap underscores the urgent need for a collaborative, multidisciplinary approach involving obstetricians, psychiatrists, pediatricians, and midwives to ensure comprehensive support and care for affected individuals.

Poor or suboptimal knowledge of appropriate antibiotic use is a cause for global concern and little is known about Central Asian countries. Therefore, this survey is aimed at evaluating awareness about antibiotic use and resistance among the adult population of Kazakhstan. A cross-sectional study of a random sample was conducted between October 2021 and February 2022 among 727 individuals without medical education and followed the methodology described in the WHO report “Antibiotic Resistance: Multi-country public awareness survey”. Half of the respondents (50.4%) received antibiotic therapy within the last 12 months, 40.1% had no prescription for this and 40.4% received no advice from a medical professional. Nearly two-thirds of respondents (65.3%) never heard about antibiotic resistance and 57.2% believed that it is worth requesting the same antibiotic if it helped to treat a similar condition previously. In general, knowledge about antibiotic use proved to be low in 82.1% of respondents and 91.9% agreed with the statement that a common cold requires antibiotics. There is a need for awareness-raising campaigns to improve the knowledge about antibiotic use and resistance in the population of Kazakhstan.

Introduction: Studying the prevalence of anxiety, depression, and insomnia among medical workers in emergency medical services is a relevant task that will improve our understanding of scope of the problem and develop effective strategies to support and prevent psychological problems among medical staff. Insomnia is closely linked to anxiety and depression, as sleep disturbances can exacerbate emotional distress, while persistent anxiety and depressive symptoms contribute to sleep disruptions. Individuals suffering from insomnia are at a higher risk of developing anxiety and depression, creating a bidirectional relationship that negatively impacts overall mental well-being. This raises a crucial question: “What specific measures and intervention strategies can be implemented to reduce the levels of anxiety, depression, and insomnia among EMS personnel?” Methods: A cross-sectional study was conducted with the participation of 592 medical workers employed in emergency medical services in the East Kazakhstan and Abay regions of the Republic of Kazakhstan. This study included questions regarding the socio-demographic data of the respondents, questions assessing the severity of insomnia using the Insomnia Severity Index (ISI), and questions from the Hospital Anxiety and Depression Scale (HADS) scale assessing the level of anxiety and depression among the participants. Results: Nearly a third of the EMS personnel reported symptoms of insomnia (28.2% subthreshold, 16.2% insomnia, and 3.0% severe), anxiety (22.1% subclinical, and 13.0% clinical), or depression (20.4% subclinical, and 9.8% clinical). Feldshers (nursing staff) and those with higher education had elevated levels of these conditions. The insomnia was strongly correlated with anxiety (r = 0.539, p < 0.001) and depression (r = 0.415, p < 0.001), emphasizing the need for targeted mental health interventions. Conclusions: This study found elevated levels of insomnia, anxiety, and depression among emergency medical service (EMS) personnel—especially nursing staff and those with higher education. We recommend comprehensive mental health support, routine screenings, stress management training, and integrating sleep hygiene into wellness programs.

Intrduction. Studying the prevalence of anxiety, depression and insomnia among medical workers of Emergency medical service is a relevant task that will allow us to better understand the scope of the problem and develop effective strategies to support and prevent psychological problems among medical staff. Methods. A cross-sectional study was conducted with the participation of 592 medical workers employed at emergency medical service in the East Kazakhstan and the Abay regions of the Republic of Kazakhstan. The study included questions regarding socio-demographic data of the respondents, questions aimed at assessing the severity of insomnia using the Insomnia Severity Index (ISI) and questions from the HADS scale to assess the level of anxiety and depression among the participants. Results. Nearly half of healthcare workers reported symptoms of insomnia (28.2% subthreshold, 16.2% insomnia, 3.0% severe), anxiety (22.1% subclinical, 13.0% clinical), or depression (20.4% subclinical, 9.8% clinical). Feldshers (nursing staff) and those with higher education had elevated levels of these conditions. Insomnia severity strongly correlated with anxiety (r=0.539, p<0.001) and depression (r=0.415, p<0.001), emphasizing the need for targeted mental health interventions. Conclusion. The study revealed high rates of insomnia, anxiety, and depression among healthcare workers, with nursing staff and highly educated individuals most affected. Insomnia correlated strongly with anxiety and depression, highlighting the need for mental health support.

Introduction. Preserving and promoting women's health is a priority issue for health care leaders. As a woman ages, the prevalence of gynecological and somatic diseases increases. The gynecologic care delivery model revealed age-related differences in women's use of gynecologic care across different care settings. The aimis to study the structure of the reasons for hospitalization of women with gynecological pathologies in hospitals in Almaty. Materials and methods. We analyzed hospitalized cases associated with gynecological diseases in Almaty city from 2013 to 2023. Data were taken from the National Scientific Center for Health Development. In addition, statistical analysis was performed using the SPSS 13.0 program. To obtain more reliable results, statistical analysis was performed based on the monthly totals of each final variable. Linear regression was used to estimate the trajectories of the resulting variables over time. This analysis was used to estimate the change in the number of diseases compared to the change over time, by 5 years. Values of p less than 0.05 are considered statistically significant. Results. The top of hospitalized cases with gynecological disease included uterine leiomyoma (D25) and female infertility (N97).Moreover, an increase in hospitalization is observed in female genital prolapse (N81) from 4.7% to 11.9%; benign ovarian neoplasm from 3.4% to 6.4% (D27). Forecast for the next five year shows that among women aged 18-39, uterine leiomyoma is likely to increase. Female infertility is expected to growth among young women, as well as an increase in female genital prolapse and benign ovarian tumors in all groups. Conclusion: Globally the prevalence of gynecological pathologies is increasing over time, particularly in young reproductive women. Primary health care in Kazakhstan needs to strengthen efforts to prevent gynecological diseases and their risk factors throughout increasing of the health literacy among females as well as implementing young specific programs. Введение. Сохранение и укрепление здоровья женщин является приоритетной задачей для руководителей здравоохранения. С возрастом женщины увеличивается распространенность гинекологических и соматических заболеваний. Модель оказания гинекологической помощи выявила возрастные различия в использовании женщинами гинекологической помощи в различных медицинских учреждениях. Целью исследования является изучение структуры причин госпитализации женщин с гинекологической патологией в стационары г. Алматы. Материалы и методы. Мы проанализировали госпитализированные случаи, связанные с гинекологическими заболеваниями, в городе Алматы с 2013 по 2023 год. Данные были взяты из Национального научного центра развития здравоохранения. Кроме того, статистический анализ был проведен с использованием программы SPSS13.0. Для получения более надежных результатов был проведен статистический анализ на основе ежемесячных итоговых значений каждой конечной переменной. Линейная регрессия использовалась для оценки траекторий результирующих переменных с течением времени. Этот анализ был использован для оценки изменения числа заболеваний по сравнению с изменением во времени на 5 лет. Значения p менее 0,05 считаются статистически значимыми. Результаты. В топ госпитализированных случаев с гинекологическими заболеваниями входили лейомиома матки (D25) и женское бесплодие (N97). Кроме того, наблюдается увеличение числа госпитализаций при выпадении женских половых органов (N81) с 4,7% до 11,9%; доброкачественном новообразовании яичников с 3,4% до 6,4% (D27). Прогноз на следующие пять лет показывает, что среди женщин в возрасте 18-39 лет лейомиома матки, вероятно, увеличится. Ожидается рост женского бесплодия среди молодых женщин, а также увеличение выпадения женских половых органов и доброкачественных опухолей яичников во всех группах. Вывод. Во всем мире распространенность гинекологических патологий со временем растет, особенно среди молодых женщин репродуктивного возраста. Первичной медико-санитарной помощи в Казахстане необходимо активизировать усилия по профилактике гинекологических заболеваний и связанных с ними факторов риска посредством повышения...