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Background: Doxorubicin (DOX) and methotrexate (MXT) are strong anticancer agents and gold standard therapy for several malignancies, with efficacy restricted by cardiotoxicity. Milk thistle extract (MTE) has demonstrated strong antioxidant and cytoprotective properties; we sought to determine the role of MTE in protection against Dox or MXT-induced cardiac damage.

Methods: A total of 35 white albino rats were divided into five groups: control, Dox alone (1.66mg/kg/48hr, IP) group, MXT alone (oral 0.5mg/kg/48hr, oral) group, Dox+MTE group (1.66mg/kg/48hr Dox IP+150mg/kg/day MTE oral), and MXT+MTE (0.5mg/kg/48hr MXT oral +150mg/kg/day MTE oral) group. The duration of experiment were seven days. A histopathological examination was done at the end of experimentation.

Results: Dox and MXT use in the rat model has induced severe cardiotoxicity with inflammatory cell infiltration, structural damage of cardiac tissue, and morphological changes. Milk thistle pretreatment extensively saved cardiac architecture.

Conclusions: MTE use with Dox or MXT demonstrated marked cardioprotection potential via reduced inflammatory cell infiltration and cardiac tissue protection, suggesting that MTE could potentially emerge as a valuable tool to block cardiac complications in Dox- or MXT-treated patients.

Introduction: In recent years, there has been a growing body of research focused on cardiorenal biomarkers associated with adverse cardiovascular outcomes. This trend reflects the ongoing need to improve diagnostic and prognostic strategies in clinical practice. At the same time, an increasing number of novel biomarkers are being identified, warranting a critical evaluation of their clinical relevance. This review examines current scientific literature addressing the role of the cardiorenal biomarkers Klotho and cystatin C, highlighting their diagnostic and prognostic potential, as well as the prospects for their integration into routine medical care.

Aim: To analyze literature data on potential cardiorenal biomarkers as predictors of adverse clinical outcomes in patients with cardiovascular diseases.

Search strategy: A literature search was conducted using the scientific databases PubMed, Web of Science, and Google Scholar, as well as electronic scientific libraries eLibrary and CyberLeninka. The search covered a five-year period (2019-2024) and focused on cardiorenal biomarkers as predictors of adverse outcomes in cardiovascular diseases.

Results: This literature review focuses on studies examining cardiorenal biomarkers of adverse cardiovascular outcomes, specifically the proteins Klotho and cystatin C. These biomarkers reflect a range of pathophysiological processes, including myocardial fibrosis, inflammation, endothelial dysfunction, and renal impairment. The analysis of current evidence suggests that the use of such biomarkers enhances the early detection of cardiovascular pathology, facilitates risk stratification, and supports dynamic patient monitoring. Their incorporation into clinical practice is contributing to the development of personalized treatment strategies and improving the precision of diagnostic assessments, ultimately leading to better clinical outcomes.

Conclusions: A review of recent literature on cardiorenal biomarkers associated with adverse cardiovascular outcomes highlights the strong diagnostic and prognostic relevance of Klotho and cystatin C. Reduced levels of Klotho have been linked to both endothelial and renal dysfunction, while cystatin C is recognized as a sensitive indicator of impaired kidney function. Further research is needed to establish standardized thresholds, refine assessment methodologies, and support the integration of these biomarkers into everyday clinical practice.

Introduction: Connective tissue dysplasia (CTD) is a common condition in children and is characterized by a variety of manifestations of the musculoskeletal and cardiovascular systems. The aim of this study was to assess the frequency, age distribution, and clinical features of CTD in children aged 3-16 years.

Materials and methods: A total of 375 children (3-16 years) were examined for signs of CTD. Clinical evaluation included analysis of musculoskeletal signs (joint hypermobility, scoliosis, flat feet, chest deformities, muscle hypotonia), phenotypic features (asthenic body type, auricular anomalies, arachnodactyly, dolichostenomelia), and cardiovascular disorders (mitral valve prolapse, conduction disturbances, accessory chords and trabeculae). Children were divided into age groups (3-7, 8-10, 11-16 years) and CTD severity (grades 1-3) to analyze the prevalence and characteristics of clinical manifestations.

Results: Signs of CTD were identified in 75 children (20%). Most cases were mild forms (grade 1- 12.8%), moderate forms (grade 2) were less common (5.9%), and severe forms (grade 3) were extremely rare (1.3%). The most common musculoskeletal manifestations were joint hypermobility (78.7%), asthenic body type (61.3%), scoliosis (54.7%), and flat feet (42.7%). Cardiovascular disorders, including mitral valve prolapse (84%) and conduction abnormalities (65.3%), were observed in all age groups. The severity of manifestations increased with the degree of CTD, whereas age differences were more pronounced for scoliosis and cardiac changes.

Conclusion: CTD in children is characterized by a persistent set of musculoskeletal and cardiovascular manifestations across various age groups, with the severity of symptoms correlating with the degree of dysplasia. Early detection and systematic clinical evaluation are essential for identifying risk groups and implementing preventive strategies for potential complications.

Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent metabolic disorders and is closely associated with insulin resistance and cardiometabolic risk. In men of working age, NAFLD frequently progresses to hepatic fibrosis and contributes to early cardiovascular remodelling, which significantly increases morbidity and mortality due to cardiovascular complications rather than liver-related outcomes.

Methods: A cross-sectional clinical-analytical study was conducted in 206 men aged 25-60 years with confirmed NAFLD. Liver fibrosis was assessed by FibroScan®. Serum LOX-1, LDLR and LRP-1 levels were measured using ELISA. Echocardiography, carotid intima-media thickness (cIMT), and flow-mediated dilation (FMD) were performed to evaluate cardiovascular function. Statistical analysis included ANOVA and correlation analysis (p<0.05).

Results: Progression of liver fibrosis (F2-F3) was associated with increased insulin resistance, atherogenic dyslipidemia, and reduced hepatic synthetic function (p<0.05). Patients with advanced fibrosis demonstrated early cardiovascular remodelling, including increased cIMT, higher left ventricular mass index, impaired diastolic function (E/e'), and decreased FMD (p<0.05). A significant increase in LOX-1 and a reduction in LDLR and LRP-1 expression indicated a shift toward a pro-atherogenic receptor phenotype (p<0.001).

Conclusion: Hepatic fibrosis in NAFLD is closely associated with an adverse cardiometabolic profile. Elevated LOX-1 levels may serve as an early biomarker of endothelial dysfunction and increased cardiovascular risk, supporting earlier identification and more intensive management of high-risk patients with NAFLD.

Clopidogrel is a second generation thienopyridine that's used as a prophylactic anti-platelets following percutaneous coronary intervention (PCI) for patients with coronary heart disease. Not all patients who receive this medication show effective response as literatures have reviewed clopidogrel resistance as an issue on needs of further follow-up and study. The aim of this article was to assess clopidogrel resistance among a group of patients who underwent PCI. This study was conducted as a cross-sectional study during the period of one year. A total of 106 patients who underwent Primary PCI and were placed on clopidogrel for at least 7 days were assessed. Their blood sample was obtained and asses for platelets aggregation test. The mean age of the patients with CAD who underwent PCI was 58.5 between 31 and 80 years old. 68.9% of them were males and 31.1% were females. From the total 106 CAD patients, 70.5% of them responded to the Clopidogrel positively and 12.4% responded in a suboptimal way while 19 patients (17.1%) were clopidogrel resistant. No significant correlation were found between clopidogrel response and gender or age; P values respectively were 0.2324 and 0.4159. subsequently, genetic report was done for resistant cases and they showed no significant correlation with age (P=0.8914) and gender (P=0.2524). Clopidogrel resistance and poor response is of a significant value among patients and can be encountered. There was no correlation of clopidogrel to age or gender, yet further studies are indicated for the assessment of the genetic material and response profile.

Background: Acanthosis nigricans (AN) is a cutaneous marker of insulin resistance and obesity, serving as an early warning sign for type 2 diabetes mellitus (T2DM). Limited epidemiological data exist on the prevalence of AN among young populations in Saudi Arabia.

Objective: To determine the prevalence of AN and its association with obesity and diabetes-related risk factors in a community-based sample in Qassim, Saudi Arabia.

Methods: A multicenter cross-sectional study was conducted between February and May 2025 in Qassim. Although the study recruited participants aged ≥10 years, the sample predominantly consisted of adults, and only about one-quarter fell within the WHO-defined youth category (10-24 years). A structured, validated questionnaire was administered to 420 participants. Obesity and AN were assessed using self-report rather than clinical examination, which may introduce misclassification bias. Fasting glucose and HbA1c values were recorded when available; however, laboratory data were only accessible for a small subset of participants and were therefore interpreted cautiously.

Results: The mean age of participants was 35.1±14.3 years. The overall prevalence of AN was 17.3%, and self-reported obesity was 24.0%. Because laboratory values were available for only a minority, related findings are considered exploratory rather than representative of the total sample. AN was significantly associated with obesity (p=0.005).

Conclusion: AN was relatively common in this mixed-age population. Given that only a small proportion of participants met the youth definition, results should not be interpreted as representing "young people" exclusively.

The high prevalence of musculoskeletal disorders among children and adolescents determines significant interest from researchers and clinicians in these conditions. Among their causes are reduced bone mineral density (BMD) and undifferentiated connective tissue dysplasia (UCTD). The pathogenesis of both conditions may be associated with trace element imbalances.

Aim of the study: To determine the frequency and pathogenetic relationships between UCTD and osteopenic syndrome in children.

Materials and methods: The group of examined children included 375 respondents (137 boys and 238 girls) from 3 to 16 years old (average age - 10.8±0.2 years). The diagnosis of UCTD was made according to the criteria of the guidelines for "Hereditary Disorders of Connective Tissue Structure and Function." All children had determined their daily calcium and vitamin D intake. Objective criteria included blood levels of 25-hydroxyvitamin D (25(OH)D), calcium, and magnesium. Densitometry of the calcaneus was performed using a Sunlight 2000 device. The χ2 criterion was used to analyze contingency tables, including for arbitrary tables.

Results: A strong association between osteopenic syndrome and the presence of UCTD was identified. When analyzing the effect of UCTD on the frequency of decreased BMD, the following statistically significant indicators were determined: χ²=37.580, critical value χ²=9.21, p<0.001. This level of significance was found between all three groups-absence of UCTD, grade 1, and grades 2-3. A significant increase in the frequency of insufficient dietary intake of vitamin D was observed in children with reduced BMD (χ²=15.848, critical value χ²=13.277, p=0.004). Similar associations were found for calcium intake (χ²=15.043, critical value χ²=13.277, p=0.005). Reduced magnesium levels were more characteristic of the subgroup of children with UCTD. For all three parameters, the highest frequency of deficiency was found in the group with a combination of osteopenic syndrome and UCTD. Differences compared to the group without pathological conditions were as follows: for 25(OH)D - RR=3.38 (χ²=47.408, critical value in all cases χ²=11.345; p<0.001), for calcium - RR=3.38 (χ²=35.831; p<0.001), and for magnesium - RR=3.38 (χ²=20.802; p<0.001).

Conclusion: The identified features of vitamin D, calcium, and magnesium intake and metabolism in children with combined decreased BMD and UCTD require special attention, as they may represent additional risk factors for the progression of these conditions and the development of complications. Their correction requires comprehensive pharmacological prevention with periodic monitoring of results.

The quality of life of healthcare workers is an important indicator of the state of the healthcare system and the quality of services provided. This study focuses on analyzing the factors affecting the quality of life of general practitioners working in urban polyclinics in Kazakhstan.

Objective: To assess the quality of life of general practitioners and identify key factors determining their physical and psychological well-being.

Methods: A cross-sectional study was conducted using the validated Russian-language version of the SF-36 questionnaire. A total of 203 physicians from five cities in Kazakhstan participated in the survey. Statistical tests, including analysis of variance and correlation analysis, were applied for data processing.

Results: The average overall SF-36 index was 58.2%. The lowest scores were recorded in the domains of social functioning and role limitations due to emotional problems. Age and marital status were found to influence specific quality-of-life domains. The proposed model for improving quality of life emphasizes the optimization of working conditions and the introduction of psychological support.

Conclusion: The results of the study demonstrate the need for systemic changes in the organization of work for general practitioners. The proposed measures may be used to improve quality of life and enhance the efficiency of healthcare professionals. A limitation of the study is the pronounced gender imbalance of the sample (92.6% women), which may affect the generalizability of the results.

Quaternary ammonium compounds (QACs) are widely used cationic surfactants known for their strong antimicrobial activity. Their utility in healthcare, consumer products, and industrial settings stems from their ability to disrupt bacterial membranes rapidly. However, increased use raises concerns about bacterial resistance and environmental persistence. The study aims to synthesize and evaluate a new series of 2-(alkyloxy)-N-(2,5-dimethylbenzyl)-N,N-dimethyl-2-oxoethanammonium chlorides (C6-C12) for antibacterial activity. Developing structurally optimized QACs may improve antibacterial potency while minimizing environmental impact and resistance selection. Tailoring the alkyl chain length and introducing degradable moieties like alkoxycarbonylmetհyl could enhance efficacy and biodegradability. The compounds were synthesized by the alkylation of N,N-dimethyl-3,6-dimethylbenzylamine with the corresponding alkyl chloroacetate. QACs were purified and characterized by IR, 1H- and 13C-NMR, and mass spectrometry. Biological activity was assessed by agar diffusion and broth microdilution assays against representative Gram-positive (Staphylococcus aureus, Bacillus subtilis) and Gram-negative (Escherichia coli, Shigella flexneri) bacteria. Comparative activity was evaluated against furazolidone. All compounds exhibited antibacterial effects using the agar-diffusion method, with inhibition zones of up to 35mm. However, the MIC values of the compounds were higher than those of the reference furazolidone. These results indicate that quaternary ammonium compounds combining a 2,5-dimethylbenzyl moiety with an alkyloxycarbonylmethyl chain exhibit moderate broad-spectrum antibacterial activity, making them promising candidates for topical and environmental applications.