Background: One of the greatest difficulties of the hearing impaired is understanding speech, especially in the presence of competitive noise. Speech perception issues are a common difficulty for those who have hearing loss. Poor speech perception is the most frequent cause of seeking hearing treatment. The most extensively used treatment to enhance speech perception is hearing aids or other assistive devices. Aim: To evaluate the effect of hearing aid methods on the speech perception of patients with hearing loss. Methods: We conducted our study based on PRISMA recommendations and guidelines. We searched Cochrane, PubMed, Scopus, and Web of Science for relevant clinical trials and prospective observational studies. Clinical trials were assessed according to Cochrane’s risk of bias tool, while observational studies were evaluated according to the National Heart, Lung, and Blood Institute. We involved the following outcomes: speech recognition thresholds, word recognition score (WRS) in noise, and WRS in quiet. Results: Six studies met the eligibility criteria for our meta-analysis. We found that hearing aids can cause an increase in WRS in noise (mean difference [MD]=18.32 [3.08, 33.55], p=0.02) and WRS in quiet (MD=45.13 [7.79, 82.46], p=0.02). In addition, hearing aids lead to a decrease in speech recognition thresholds (MD=45.13 [7.79, 82.46], p=0.02). Conclusions: Hearing aids are an effective treatment for patients with hearing loss. They can significantly improve speech perception (WRS) in quiet and noisy environments and provide other benefits, such as improved communication, increased safety, and better cognitive function. If you or someone you know has hearing loss, it is essential to speak with a healthcare professional about the benefits of using hearing aids.

Introduction Microtia and aural atresia present congenital ear anomalies that affect external ear and are associated with conductive hearing loss. Both anomalies result from exposure to various prenatal risk factors, most common during the first trimester of pregnancy. Objective This study was aimed at epidemiological analysis of microtia/atresia and associated risk factors in the Kazakhstani population. Methods A retrospective study in two stages. First, a cross-sectional analysis of microtia/ atresia frequencies from 2015 to 2019 on the basis of official statistics obtained from the Republican Centre for E-Health. Then, a case-control study was carried out to elucidate maternal risk factors associated with occurrence of microtia/atresia. We recruited patients presented in Almaty, Kazakhstan, between September 2021 and February 2022. Results There was a substantial regional variation in the rates of both aural atresia and microtia/anotia. Mothers of children with microtia disclosed toxoplasmosis, other agents (including HIV, syphilis, varicella), rubella, cytomegalovirus, herpes simplex (TORCH) infections during pregnancy more often than those of healthy children (45.8 versus 7.3%; p < 0.001). Exposure to different chemicals during pregnancy was mentioned more frequently by mothers of children with microtia when compared with the healthy controls (18.1 versus 8.1%; p = 0.035). Self-reporting of alcohol consumption and intake of antibiotics was also significantly higher in mothers of children with microtia (31.9 and 36.1% respectively). Conclusion Elucidation of microtia/atresia epidemiology is important due to their imposed social and economic burden, associated with treatment and rehabilitation costs.

Background: Patients with coronary artery disease (CAD) receiving dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remain at risk of early adverse outcomes, including in-hospital mortality. Simple risk stratification based on routinely available variables may help identify higher-risk patients, but a limited number of outcome events constrains robust prediction-model development and validation. Aim: This exploratory study aimed to derive a preliminary, interpretable clinical score based on routinely available variables for risk stratification of all-cause in-hospital mortality in CAD patients receiving DAPT after PCI. In the clopidogrel-dominant practice setting of the participating centers, the score was conceived as a hypothesis-generating risk-enrichment framework rather than a validated treatment-selection tool or a surrogate measure of platelet reactivity. Methods: We analyzed a retrospective cohort of 1600 adults with CAD admitted between 2022 and 2024; 36 in-hospital deaths occurred. Twenty demographic, clinical, laboratory, and instrumental variables were evaluated. The primary outcome was all-cause in-hospital mortality during the index hospitalization. For exploratory score derivation, the dataset was randomly divided into a derivation subset (75%; n = 1200) and a hold-out assessment subset (25%; n = 400). Predictors were explored using univariable and multivariable logistic regression with stepwise selection. Continuous variables were categorized using Weight of Evidence binning, and an integer point score was derived. Performance was summarized using ROC analysis, AUC, sensitivity, specificity, and accuracy. Given the small number of deaths and the data-driven modelling workflow, all performance estimates were considered preliminary rather than definitive internal validation. Results: The exploratory six-variable score included age ≥ 57 years, estimated glomerular filtration rate < 45 mL/min/1.73 m², body mass index ≥ 25 kg/m², troponin I ≥ 100, prior myocardial infarction, and current smoking. In the derivation subset, each additional point was associated with higher odds of mortality (OR 1.39; 95% CI 1.29–1.51; p < 0.001), and the AUC was 0.654. A Youden-index threshold of approximately 6 points yielded sensitivity of 0.41, specificity of 0.80, and accuracy of 0.72. In the hold-out assessment subset, sensitivity was 0.53, specificity was 0.70, accuracy was 0.70, and AUC was 0.61. These estimates indicate modest discrimination and should be interpreted cautiously because only 36 outcome events were available. Conclusions: This exploratory clinical score showed modest discrimination for all-cause in-hospital mortality and should be regarded as a preliminary, hypothesis-generating risk-stratification approach. It is not sufficiently validated for routine prognostic classification, platelet-reactivity triage, or antiplatelet treatment selection. Model redevelopment using event-efficient methods, resampling-based internal validation, and subsequent external validation are required before clinical implementation.

Introduction. The rapid and frequent emergence of novel psychoactive substances (NPS) contributes to increasing workload for forensic medical examination and clinical toxicology services. Existing analytical methods cannot cope with the growing volumes of data from modern high-resolution mass spectrometry, necessitating the introduction of advanced approaches, primarily artificial intelligence methods. Objective. To investigate and systematize international experience in applying artificial intelligence in forensic medicine and pharmacology for analyzing novel psychoactive substances, and to propose practical recommendations for implementation in Kazakhstan. Search strategy. A thorough narrative review of 78 international literature sources was conducted, covering analytical methods of liquid chromatography coupled with high-resolution mass spectrometry, data processing standards, substance identification libraries, machine learning algorithms, clinical protocols, and pharmacovigilance systems. Results. Key components of an integrated system were identified: standardization of data formats (mzML, mzTab-M), specialized computational processing tools (XCMS, MZmine, OpenMS, MS-DIAL), spectral libraries (MassBank, mzCloud), computational identification methods (SIRIUS, CFM-ID, GNPS), a grading system for result reliability (Schymanski confidence levels), clinical antidote therapy protocols, and international information exchange channels on emerging threats (EudraVigilance, FAERS, VigiBase, EU EWS, EMCDDA, UNODC). Conclusions. Effective implementation of artificial intelligence requires compliance with international data compatibility standards, rigorous validation of machine learning algorithms, and integration with international monitoring systems. The proposed recommendations ensure scalability of solutions regardless of local regulatory specificities. Введение. Быстрое и частое появление новых психоактивных веществ (НПВ) приводит к увеличению рабочей нагрузки на судебно-медицинские экспертизы и клиническую токсикологию. Существующие аналитические методы не справляются с растущими объемами данных, получаемых с помощью современной масс-спектрометрии высокого разрешения, что обусловливает необходимость внедрения передовых подходов, прежде всего методов искусственного интеллекта. Цель. Исследовать и систематизировать международный опыт применения искусственного интеллекта в судебной медицине и фармакологии для анализа новых психоактивных веществ и предложить практические рекомендации по его внедрению в Казахстане. Стратегия поиска. Проведен тщательный обзор 78 международных литературных источников, охватывающих аналитические методы жидкостной хроматографии в сочетании с масс-спектрометрией высокого разрешения, стандарты обработки данных, библиотеки идентификации веществ, алгоритмы машинного обучения, клинические протоколы и системы фармаконадзора. Результаты. Были определены ключевые компоненты интегрированной системы: стандартизация форматов данных (mzML, mzTab-M), специализированные инструменты вычислительной обработки (XCMS, MZmine, OpenMS, MS-DIAL), спектральные библиотеки (MassBank, mzCloud), методы вычислительной идентификации (SIRIUS, CFM-ID, GNPS), система оценки достоверности результатов (уровни доверия Шиманского), протоколы клинической антидотной терапии и международные каналы обмена информацией о возникающих угрозах (EudraVigilance, FAERS, VigiBase, EU EWS, EMCDDA, UNODC). Выводы. Эффективное внедрение искусственного интеллекта требует соблюдения международных стандартов совместимости данных, строгой проверки алгоритмов машинного обучения и интеграции с международными системами мониторинга. Предложенные рекомендации обеспечивают масштабируемость решений независимо от местных нормативных особенностей. Кіріспе. Жаңа психобелсенді заттардың (ЖПЗ) тез және жиі пайда болуы сот-медициналық сараптама және клиникалық токсикология қызметтеріне түсетін жүктеменің артуына әкеледі. Қолданыстағы талдау әдістері қазіргі заманғы жоғары ажыратымдылықтағы масс-спектрометриядан алынатын деректердің өсіп келе жатқан көлемін өңдеуге қауқарсыз, бұл озық тәсілдерді, ең алдымен...

Введение. Наиболее эффективными для лечения аллергического ринита являются пероральные антигистаминные препараты и интраназальные кортикостероиды; в то же время существуют данные, которые говорят о преимуществе в использовании кортикостероидов ввиду лучшего устранения симптомов у пациентов. Цель исследования. Оценить эффективность двух антигистаминных препаратов второго поколения (цетиризина и левоцетиризина) и двух назальных кортикостероидов (мометазона и флутиказона фуроата) у пациентов с аллергическим ринитом, а также сравнить клинические результаты. Материалы и методы. В исследование были включены 288 пациентов с аллергическим ринитом, проживавших в городе Алматы и получавших цетиризин, левоцетиризин, мометазона фуроат или флутиказона фуроат. Эффективность лечения оценивалась с использованием общей шкалы оценки назальных симптомов (TNSS), где результаты варьировались от 0 до 12, где 0 означал отсутствие симптомов. Результаты и обсуждение. Все пациенты прошли трехмесячное наблюдение. Из них 75% принимали антигистаминные препараты, 20% – кортикостероиды, 5% – комбинированные препараты. Средний показатель TNSS для кортикостероидов составил 2,5 балла, для антигистаминов – 5 баллов, а для комбинированных препаратов – 4 балла. Выявлены различия между эффективностью приема кортикостероидов и антигистаминов. Выводы. В лечении аллергического ринита чаще назначаются пероральные антигистаминные препараты второго поколения, чем местные интраназальные кортикостероиды. Однако пациенты, получавшие кортикостероиды, показывали более эффективный контроль симптомов аллергического ринита.

Результаты опросников THI и TRQ показали, что использование программы фрактального тона снизило нагрузку на шум в ушах у 90% пациентов с 440 слуховыми аппаратами. Чем ниже возраст пациента, тем больше терапевтический эффект от использования программы. По мере увеличения количества баллов уменьшалась вероятность положительного эффекта фрактальных тонов. The results of the THI and TRQ questionnaires showed that the use of the fractal tone program reduced the burden of tinnitus in 90% of patients with 440 hearing aids. The lower the age of the patient, the greater the therapeutic effect of using the program. As the number of points increased, the probability of a positive effect of fractal tones decreased.