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Background: Neck pain is a common musculoskeletal condition which is becoming more common in undergraduate students due to the modification in modern lifestyle, learning methods, and the use of electronic devices.

Aim: To assess the prevalence of neck pain and its associated factors among Baghdad undergraduate students.

Materials and methods: A descriptive cross-sectional study was performed by means of a self-administered online questionnaire distributed among the undergraduate students in December 2023. GraphPad Prism was used to analyse data from 520 students.

Results: The study involved 520 college students (198 males and 322 females). The overall prevalence of neck pain was 74.23% (95% CI: 70.30-77.80%), and it was higher in females (81.37%) than in males (62.63%). Statistically significant associations were found between neck pain and gender (p<0.0001), duration of electronic device use (p<0.0001), family history of neck pain (p<0.0001), age (p=0.0036), and study position (p=0.0127).

Conclusion: Neck pain prevalence was 74.23% among undergraduate students in Baghdad, with female gender, age, prolonged electronic device use, poor study posture, and family history found as significant associated factors. Despite the methodological limitations, the findings highlight the necessity for preventive strategies that focus on ergonomic education and performing future multi-institutional studies with multivariate analysis.

Pain caused by injection is influenced by various factors including the type of anesthetic used, injection technique, needle gauge and size, injection speed, and individual patient characteristics. Technical and pharmacological advances, such as the use of modern equipment, buffering and warming solutions, or reducing pain with gels and numbing agents, aim to minimize the pain associated with injections. Investigating the factors influencing injection pain can lead to improvements in the quality of dental treatments and increase patient satisfaction. Hence, a systematic review was conducted to methodically examine the determinants affecting pain related to local anesthetic injections in the oral cavity. All stages of the study design were conducted based on the PRISMA guidelines. A comprehensive and extensive review of scientific and research article databases including PubMed, Web of Knowledge, Google Scholar, and Scopus was performed for the period from January, 2013, to January, 2024. Extracted information included authors, country, year, pain level, injection site, type of anesthetic, type of equipment used for injection, gender of patients, age of patients, factors affecting the level of pain during injection, and conclusions. The findings indicate that patients' individual characteristics, the type of substance and needle, and modern techniques and equipment like laser and microneedle patches are effective in reducing injection pain. Attention to psychological factors and the use of appropriate tools based on the injection site play a crucial role in pain management; however, some methods require further research for standardization.

Temporomandibular joint dysfunction (TMJD) represents a multifactorial disorder that extends beyond the articular complex to include neuromuscular, postural, and psychosomatic dimensions. This literature review analyzes the integration of osteopathic medicine into the multidisciplinary management of TMJD. The study explores five osteopathic models-biomechanical, neurological, metabolic-energetic, respiratory-circulatory, and behavioral-psychosocial-emphasizing their clinical significance for functional rehabilitation within the cranio-cervico-mandibular system. Evidence suggests that osteopathic manipulative treatment (OMT) significantly reduces pain, improves mandibular mobility, and restores neuromuscular balance when combined with conventional dental and physiotherapeutic modalities. However, limitations in existing research-including small sample sizes, heterogeneous methodologies, and lack of objective digital assessments-underscore the need for further randomized controlled trials employing standardized protocols and AI-based cephalometric tools to substantiate clinical outcomes.

Background To analyze the correlation between loneliness and perceived stress in the elderly, and to explore the chain mediating effect of perceived social support and a sense of meaning in life on loneliness and perceived stress. Methods Convenient cluster sampling was used to conduct a survey on 634 elderly people in Wuhu City, Anhui Province, using the UCLA Loneliness Scale (UCLA), Perceived Social Support Scale (PSSS), Meaning of Life Questionnaire (MLQ), and Perceived Stress Scale (PSS). Results Loneliness was positively correlated with perceived stress (r=0.26, P<0.01); Perceived social support was negatively correlated with loneliness and perceived stress (r=-0.28, -0.35, P<0.01). The sense of meaning in life was negatively correlated with loneliness and perceived stress (r=-0.24, -0.34, P<0.01). Perceived social support plays a mediating effect between loneliness and perceived stress. The sense of meaning in life plays a mediating effect between loneliness and perceived stress. Perceived social support and a sense of meaning in life play a chain mediating effect between loneliness and perceived stress. Conclusion The research results reveal the synergistic protective effect of psychosocial resources and cognitive evaluation factors in alleviating the impact of loneliness on stress perception, providing a theoretical basis and practical direction for mental health intervention for the elderly.

Introduction: Despite the inclusion of dental examination in the screening package of the guaranteed volume of free medical care (GVFMC), the coverage of pregnant women with dental care in Kazakhstan remains extremely low. Untimely treatment, lack of awareness and financial barriers contribute to the deterioration of the oral cavity and the increased risk of pregnancy complications.

Materials and methods: As part of the doctoral thesis, a survey of 455 pregnant women was conducted from September to December 2024 on the basis of voluntary informed consent. The author's questionnaire was used with questions about seeking dental care. The analysis included descriptive characteristics, medians and interquartile range, and comparison of index of caries according to the Kruskal-Wallis test. Additionally, a retrospective analysis of CSHI tariffs for 2020-2024 for key types of dental services was conducted, taking into account their importance for pregnant women and comparing them with clinical results.

Results: Only 17.6% of women went to the dentist during pregnancy, only 4.8% of them - for preventive purposes. The median index of caries was 6.0 (IQR: 5.0-7.0) for those who did not apply, and 2.0 (IQR: 2.0-3.0) - for those referred by an obstetrician-gynecologist, p<0.001. Despite the fact that 81.3% were registered before the 10th week, few people received preventive care, which indicates routing problems. Only 14% patients were fully informed, and 65% patients paid extra for treatment. Complaints were related to inattentive attitude (28%), insufficient qualifications (22%) and inconvenient schedule. The analysis of CSHI tariffs showed a slowdown in growth in 2024 after a jump in 2021-2023, which worsens the gap between real costs and service coverage.

Conclusion: The study revealed low coverage, insufficient information and economic barriers. Interdisciplinary collaboration needs to be strengthened, routing needs to be improved, and tariff policies need to be reviewed.

Background: Postnatal depression (PND) is a significant public health concern affecting the health of the mother, child, and family. Despite its high prevalence, Kazakhstan lacks a validated screening tool, which complicates early detection at maternity hospitals and primary care facilities.

Aim: The aim of the study was to translate, culturally adapt, and psychometrically validate the Edinburgh Postnatal Depression Scale into Kazakh.

Materials and methods: The study included 107 women in the early postpartum period. Translation was performed according to international standards (forward-backward translation, expert review). All participants underwent a psychiatrist's clinical interview (gold standard). Internal consistency (Cronbach's α), test-retest reliability (ICC(2,1)), classification agreement (Cohen's κ), and discriminative ability via ROC analysis were assessed.

Results: Signs of mild PND were identified in 30 women (28.0%). The Kazakh version of Edinburgh Postnatal Depression Scale (EPDS) showed good internal consistency (α=0.86) and excellent test-retest reliability (ICC=0.99; 95% CI: 0.985-0.993). Cohen's κ at the ≥7 threshold was 0.90 (95% CI: 0.82-0.96), with a simple agreement rate of 95.3%. ROC analysis demonstrated good discriminative ability (AUC=0.88; 95% CI: 0.824-0.949; p<0.001). The optimal cut-off defined by Youden's index was ≥7, yielding 80.0% sensitivity and 75.3% specificity.

Conclusions: The Kazakh version of EPDS is a reliable and valid tool for PND screening. A cut-off score of ≥7 is recommended for use in primary care to identify women at risk and ensure timely referral to specialists.

Background: Early-life stress is a known risk factor for adult cognitive deficits, mediated in part by disruption of hippocampal estrogen receptors and neurotransmitter systems. Tamoxifen, as a selective estrogen receptor modulator, worsens cognitive function. Electromagnetic stimulation (EMS) helps improve this process.

Aim: The aim of study was investigating the effects of early-life immobilization stress and tamoxifen on hippocampal ERα, ERβ, NMDA, AMPA, and GABA receptor expression in rats, and to evaluate whether EMS mitigates these effects.

Methods: Newborn rats were divided into six groups (n = 7/group): control, control+EMS, immobilization, immobilization+EMS, tamoxifen, and tamoxifen+EMS. Chronic immobilization or tamoxifen was applied during postnatal days 1-20. EMS was applied during days 21-30. Receptor levels were quantified via appropriate biochemical assays on postnatal day 80.

Results: Tamoxifen significantly suppressed ERα and ERβ expression, while stress mainly reduced ERβ. NMDA receptor levels were reduced by both tamoxifen and stress. AMPA receptors was increased by tamoxifen but normalized by EMS. GABA receptors expression increased in stressed and tamoxifen groups, and decreased with EMS. EMS significantly restored ERβ and partially normalized NMDA and GABA levels.

Conclusion: Early-life stress, as well as tamoxifen, disrupt hippocampal receptor homeostasis, which may lead to cognitive decline in adulthood. EMS has the potential to normalize these neurochemical alterations. Research in this direction may contribute to the development of new therapeutic approaches aimed at preventing stress-induced impairments originating in early life.

Objective: To review the clinical pictures and diagnostic experience for autoimmune encephalitis (AE) with positive antibodies of anti-GAD65, anti-GABAARα1 and anti-mGluR5 detected in the cerebrospinal fluid (CSF), so as to provide a reference for following diagnosis and treatment of this group of patients.

Methods: A retrospective analysis was conducted on one cases of AE with positive anti-GAD65, anti-GABAARα1 and anti-mGluR5 antibodies in CSF. The data reviewed in this reported included the clinical manifestations, the findings of brain magnetic resonance imaging (MRI), CSF properties, treatment regimen and prognosis, and related literatures were reviewed as well.

Results: The patient was male, aged 51 years old, presented with acute onset and progressive worsening of symptoms. The major manifestations included refractory epilepsy, abnormal mental behaviors, and memory decline. Head MRI revealed lesions in the deep right temporal lobe and occipital lobe. CSF testing showed positive results for triple antibodies of anti-GAD65, anti-GABAARα1, and anti-mGluR5, based on which a definitive diagnosis of autoimmune encephalitis was made. He received symptomatic and supportive treatments, including antiepileptic, anti-infective, and immunotherapies. Nevertheless, the patient still presented with refractory epilepsy, and developed respiratory failure after admission to the intensive care unit. Unfortunately, the patients were dead from critical condition.

Conclusion: The clinical pictures are not specific in AE patients with positive antibodies of anti-GAD65, anti-GABAARα1, and anti-mGluR5, and the prognosis is poor in this group of patients because of poor response to the standard immunotherapies and antiepileptic drugs. Therefore, it is necessary to make definite diagnosis in the early stage of disease, and explore effective treatment regimens for this condition.

Introduction: Ear, nose, and throat (ENT) disorders are among the most frequent reasons for outpatient and emergency visits. Assessing public knowledge and awareness of common ENT-related issues is essential for early detection, prevention, and appropriate healthcare-seeking behavior.

Methods: This cross-sectional study was conducted among 415 residents of the Qassim region, Saudi Arabia, aged 18 years and above. Data were collected using a validated electronic questionnaire assessing demographic characteristics and knowledge of common ENT-related issues. Data were analyzed using SPSS version 26, and associations between knowledge level and demographic factors were evaluated using the Chi-square test.

Results: Most participants (69.4%) disagreed that cotton buds are a safe method for ear cleaning, while 60.2% correctly recognized that newborn hearing can be screened. The majority (86.7%) agreed that sudden hearing loss requires immediate medical assessment, and 89.1% identified that inner ear infections can cause vertigo. Overall, 78.6% of participants demonstrated an acceptable knowledge level about ENT-related issues. Females showed significantly higher knowledge levels than males (p=0.003), whereas no significant associations were found with age, education, or occupation.

Conclusion: The study revealed generally acceptable awareness of ENT-related issues among the population of the Qassim region, with notable gender differences favoring females. These findings emphasize the need for targeted health education programs to improve public understanding of ENT disorders and promote preventive practices.

Background: Minimally invasive transforaminal lumbar interbody fusion - TLIF (MIS-TLIF) may reduce perioperative morbidity compared with conventional open TLIF, but evidence from middle-income healthcare systems is limited.

Aim: To compare clinical outcomes, radiological fusion, and early postoperative recovery between open TLIF and MIS-TLIF.

Methods: Forty-one patients undergoing one- to three-level TLIF for degenerative lumbar conditions were retrospectively analyzed (22 open, 19 MIS). Outcomes included operative time, blood loss, hospital stay, pain intensity (VAS), Oswestry Disability Index (ODI), radiation exposure, and fusion grade (Bridwell system).

Results: MIS-TLIF was associated with shorter operative times (267±14 vs. 351±12 min), lower blood loss (107±4 vs. 331±25 mL), and shorter hospitalization (4.2±0.3 vs. 6.7±0.5 days; all P < 0.0001). Early pain recovery was faster (VAS on day 12: 1.3 vs. 2.2; P ≤ 0.0007). Functional improvement, assessed using the Oswestry Disability Index (ODI) at approximately 6 months postoperatively, paralleled these findings, decreasing from 85.63±5.18% to 10.27±2.66% in the open TLIF group, and from 85.47±6.21% to 6.10±2.70% in the MIS-TLIF group. Fusion rates were comparable, while fluoroscopic exposure was higher in MIS-TLIF (137.8±9.6 vs. 53.2±3.1 μGy). No complications occurred in MIS-TLIF; open TLIF had one revision for cage migration and one superficial wound infection.

Conclusions: MIS-TLIF provides superior perioperative outcomes and faster early pain recovery with comparable fusion rates. Increased radiation exposure remains a consideration. These findings support MIS-TLIF as an effective alternative to open TLIF in middle-income healthcare settings.