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Background: Environmental exposures are increasingly linked to reproductive dysfunctions such as endometriosis, ovarian insufficiency, and polycystic ovary syndrome (PCOS). Through endocrine disruption, oxidative stress, and epigenetic pathways, heavy metals (such as cadmium [Cd], lead [Pb], mercury [Hg], and arsenic [As]) and trace elements (such as zinc [Zn], copper [Cu], and selenium [Se]) may affect female fertility. Nevertheless, there are still few integrated assessments that address their combined consequences. The goal is to perform a critical evaluation and systematic analysis of epidemiological data about the link between reproductive health issues in women of reproductive age and exposure to heavy metals and trace elements.

Methods: A comprehensive literature search was carried out in PubMed, Scopus, Google Scholar, and Web of Science to locate articles published between 2010 and 2024. Included were observational human studies that looked at correlations between metal exposure and the reproductive results of females. The study's quality was assessed using the Newcastle-Ottawa Scale (NOS), and the review process adhered to PRISMA guidelines.

Findings: A total of twenty-three studies were included in the review: eleven case-control studies, eight cross-sectional studies, three cohort studies, and one analytical study. Cd, Pb, As, Hg, Cu, and Zn were the most frequently evaluated elements; these were usually detected in biological samples such blood, serum, or follicular fluid. While low Zn and Se levels were linked to endometrial diseases and a reduced ovarian reserve, elevated levels of Cd, Pb, and As were linked to an increased risk of PCOS and endometriosis. Inflammation and endocrine dysregulation were inversely correlated with protective trace elements, especially zinc and selenium. 17 studies had a high-quality rating (NOS score ≥7).

Conclusions: One important and controllable risk factor for the reproductive health of women is exposure to hazardous metals. It seems that preserving reproductive function depends on striking a balance between harmful and necessary components. To elucidate dose-response connections, synergistic effects, and possible therapeutic options, further prospective and mechanistic research is required.

Background: The potential of virtual reality (VR) in medical education in Kazakhstan proved substantial, offering innovative learning methods and creating secure, interactive training environments that facilitated the acquisition of both theoretical knowledge and practical skills.

Material and methods: This study aimed to evaluate the application and effectiveness of virtual reality in medical education through a survey conducted with 53 students and 20 teachers. To assess the perceptions and satisfaction with VR in medical education, a survey was conducted utilizing a scale from 1 to 10.

Results: Findings from the survey revealed that students perceived significant advantages in using virtual reality to grasp complex medical concepts and hone clinical skills. They appreciated the opportunity to apply theoretical knowledge in practice, the availability of high-quality content across various disciplines, and the safe learning conditions provided.

Conclusion: Teachers recognized virtual reality as a valuable educational tool but highlighted some challenges, including insufficient training and limited access to equipment. Addressing these obstacles is crucial for the successful integration of virtual reality into training programs, thereby unlocking its full potential and enhancing educational outcomes.

Objective: To investigate the role of hypercorticism in the pathogenesis of acute radiation sickness (ARS) and under conditions of increased radioresistance, assessing the theoretical and clinical significance of impaired protein-steroid interactions.

Materials and methods: An analysis was conducted of experimental data from irradiated animal models: chinchilla rabbits (n=20), dogs (n=15), WISTAR rats (n=63), guinea pigs (n=49), and BALB/c mice (n=32). Some animals underwent adrenal autotransplantation. Fluorometric and gel filtration methods were used to assess protein-steroid interactions; total-body γ-irradiation was administered at doses inducing grade IV ARS. Data were statistically processed using Student's t-test.

Results: A biphasic adrenocortical response to radiation was observed in most species, whereas rabbits exhibited a monophasic decline in corticosteroid levels. During the peak of ARS, impaired corticosteroid-binding globulin (CBG) function led to increased levels of free, biologically active corticoids, even with normal or reduced total 11-oxycorticosteroids. A consistent radiobiological pattern was established: an increase in the free hormone fraction due to diminished CBG binding capacity. Adrenal autotransplantation prior to irradiation reduced corticoid levels, enhanced CBG binding capacity during ARS, and decreased free corticoid concentrations, resulting in a protective effect and increased radioresistance.

Conclusion: The findings underscore the critical role of corticosteroid regulation and CBG functional status in the body's response to radiation exposure. Modulation of adrenal activity and correction of protein-steroid interactions may be considered a promising strategy for enhancing radioresistance.

Background: Gestational Diabetes Mellitus (GDM) is a significant medical problem worldwide and the cause of many complications for the mother and the foetus, in terms of pregnancy management and outcome. Early assessment of the risk of diabetes in pregnant women with hyperglycaemia is particularly important, as it allows timely preventive measures to help avoid potential complications Aim: Our aim was to identify microRNAs that could enable the assessment of diabetes risk in pregnant women with hyperglycaemia.

Methods: The study analyzed the expression of the following microRNAs: miR-132, miR-29a, miR-222, miR-93and miR-17-5p, from the blood samples of pregnant women with hyperglycaemia, with gestational diabetes mellitus, with type 1 or type 2 diabetes and healthy pregnant between 24 and 28 weeks of their pregnancy. The miR-17-5p was used as a reference.

Results: A significant difference in the miR-222 and miR-29a expression level was found in plasma samples. Compared to the control group Among pregnant patients with hyperglycaemia miR-222 and miR-29a in some sample exhibit increased levels while others show reduced levels-suggesting its potential for subgroup differentiation within this population. MiR-93 remains uniformly low in in Diabetes, GDM, Hyperglycaemia groups compared to the control group. A significant difference in the miR-93 expression level was found in plasma samples. miR-132 is also upregulated in GDM and diabetic patients, with the highest levels observed in the diabetic group, compared to the control group. In contrast, its expression fluctuates among pregnant women with hyperglycaemia.

Conclusion: The wide variability in the expression levels of miR-29a, miR-222 and miR-132 suggests that they may serve as useful predictive biomarkers for evaluating diabetes risk in hyperglycemic pregnant women. Further studies involving longitudinal follow-up of hyperglycaemic pregnant women are needed to determine the predictive value of these microRNAs.

Introduction: The study of acute toxicity is considered an integral part of any medical substance's preclinical evaluation. Changes in the psycho-emotional state are among the important indicators of the neurotoxic effects of various substances on animals and humans. Non-conflict methods of research are gaining increasing popularity as the most humane approaches with respect to animals, among which methods based on ethological approaches play a central role.

Materials and methods: A nanocellulose-based biocomposite was used as the implantable material. The study was conducted on 25 rats and included the formation of a defect in the mid-diaphysis of the femur followed by filling with either the biocomposite (10) or an autologous blood clot (10). Additionally, implantation into soft tissues was performed (5). The animals were observed for 14 days, during which clinical symptoms were assessed and open field and elevated plus maze tests were conducted.

Results: The nanocellulose-based biocomposite did not exhibit pyrogenic activity when implanted into bone and soft tissues. Assessment of several behavioral acts and states revealed no statistically significant differences in locomotor and exploratory activity between the experimental and control groups. The analysis of the indicators shows that the tested substance does not exert an acute toxic effect on the nervous system.

Background: The development of e-pharmacies has significantly expanded public access to pharmaceutical products. At the same time, the rapid growth of e-commerce, the globalization of digital services and the expansion of cross-border trade in medicines have created new risks for consumers. These include violations of the conditions of storage and transportation of medicines, distribution of low-quality or counterfeit products, increased cases of self-medication, uncontrolled or illegal interference by third parties in the delivery process, etc. Aim: The purpose of the study is to analyze legal challenges and improve consumer protection mechanisms in the field of electronic commerce of medicines at the national and international levels.

Materials and methods: The study applies an interdisciplinary approach combining doctrinal legal analysis, comparative legal methodology, and empirical review of international regulatory practices. Legal acts, WHO and EU documents, FDA guidelines, and statistical data were examined to identify best practices for consumer protection in the field of e-commerce in medicines.

Results: The results of the study indicate that the legal regulation of relations in the field of electronic pharmaceutical services in the legislations of many countries is insufficient. It is emphasized that fragmented legal regulation, lack of harmonized international standards and insufficient supervision in the field of medicines circulation pose a significant threat to the health, safety and privacy of consumers.

Conclusions: It is concluded that effective consumer protection of digital services requires strengthening of regulatory requirements for e-commerce in medicines, in particular, introduction of clear rules for registration and licensing of online pharmacies, regulation of creation of relevant web resources, protection of personal data of consumers, etc. The author proposes a set of legal and institutional measures aimed at ensuring effective protection of the rights of consumers using the services of online pharmacies.

Background and aim: Hypertension is an unparalleled risk factor among cardiovascular diseases (CVD) and has been reported to target over 1.4 billion people globally. The Omega-3 polyunsaturated fatty acids (PUFAs), especially the eicosapentaenoic acid (EPA) and the docosahexaenoic acid (DHA) have been put forward as possible non-pharmacological interventions to control blood pressure because they are known to be vasoactive. The purpose of the systematic review was to summarize available evidence on the vasoactive properties of omega-3 PUFAs, and how these properties apply in managing hypertension and reduction of cardiovascular risk.

Methods: Systematic review was done in compliance with the PRISMA guidelines. The search in PubMed, Scopus, and Web of Science was conducted to identify the publications published between 2010 and 2025. Inclusion criteria were randomized controlled trials, cohort studies, and other related meta-analyses on the effect of EPA and/or DHA on blood pressure, and endothelial function, inflammation, lipid metabolism, and cardiovascular outcomes. Synthesis of data was done in the form of systematic narrative without quantitative pooling.

Results: Randomized controlled trial evidence has shown that omega-3 PUFA supplementation is linked with slight systolic and diastolic blood pressure decreases especially in hypertensive or those with high cardiometabolic risk persons. These effects have been shown to mediate via enhancement of endothelial nitric oxide bioavailability, reduction of vascular inflammation and positive remodeling of lipid profiles. Diversity of the outcomes of the studies was noticed and probably it is the difference in dosage, ratios of EPA:DHA, duration of the intervention, and the population specifics at the baseline.

Conclusion: Omega-3 PUFAs have shown promise as supplemental agents in the process of controlling hypertension and prevention of cardiovascular disease by a variety of complementary vasoactive pathways. Nonetheless, the heterogeneity of the studies does not allow conclusive findings on the best dosing strategies. Standardized hypertension-oriented large-scale randomized controlled trials conducted in the future are justified to improve clinical practice.

Introduction: Atherosclerotic cardiovascular diseases remain the leading cause of mortality worldwide, with chronic inflammation driving progression despite traditional lipid-lowering and antiplatelet therapy, leaving substantial residual cardiovascular risk. This study aimed to systematically analyze immunomodulator efficacy and safety in treating atherosclerosis and chronic cardiac diseases, determining therapeutic potential and associated risks.

Methods: A systematic search of Scopus, Web of Science, PubMed, Embase, and the Cochrane Library identified 264 records. After removing 134 duplicates and screening 130 unique records, 74 studies (20 randomized controlled trials, 16 systematic reviews/meta-analyses, 22 prospective cohort studies, 9 retrospective analyses, and 7 experimental studies) were selected that met the inclusion criteria and were included in the qualitative synthesis according to PRISMA 2020.

Results: Three main immunomodulator categories demonstrated cardiovascular efficacy: interleukin-1β inhibitors (canakinumab reduced events by 15%), small anti-inflammatory molecules (colchicine achieved 23-31% risk reduction), and interleukin-6 receptor antagonists (tocilizumab reduced infarct size by 12.4%). However, biological agents showed increased infectious complications, with canakinumab demonstrating statistically significant fatal infection increase. Immunomodulatory therapy represents transformative advancement targeting inflammatory mechanisms beyond lipid reduction. Colchicine emerged as priority drug for clinical implementation given optimal efficacy-cost ratio and favorable safety profile, while biologics face economic barriers exceeding $70,000 annually.

Conclusions: Long-term monitoring of immunosuppressive therapy safety profiles, particularly regarding infectious complications and oncological risks, remains critically important for future large-scale studies requiring decade-long surveillance in diverse populations.

Background: Osteoporosis is a serious public health problem worldwide, especially among the aging population. It is characterized by low bone mineral density (BMD), which leads to an increased risk of fractures. Despite the growing burden, data on the prevalence of osteoporosis and related risk factors in Kazakhstan are limited. The purpose of this study was to assess the state of BMD and identify key risk factors associated with osteoporosis among adults aged 45 years and older in the Abay region of Kazakhstan.

Methods: The cross-sectional study was conducted from July 2023 to March 2024 with 367 women. Data collection included measurement of BMD using dual-energy X-ray absorptiometry (DXA), a standardized questionnaire adapted by the International Osteoporosis Foundation, and laboratory tests (vitamin D, calcium, and alkaline phosphatase levels). The participants were grouped by age and BMD status. Statistical analysis included the chi-square criterion or Fisher's exact criterion for categorical variables and the Mann-Whitney U-test or Kruskal-Wallis criterion for continuous variables. Logistic regression was used to study the relationship between low BMD and demographic factors, lifestyle, and nutrition.

Results: Osteopenia and osteoporosis were detected in 25.3% and 21.0% of participants, respectively, and their prevalence was significantly higher among people aged 56-65 years (p<0.004). Regression analysis showed that low BMD was significantly associated with older age (AOR 1.034; p=0.025), weight (AOR 0.975; p=0.071), lower BMI (AOR 0.989; p=0.764).

Conclusions: This study highlights the high prevalence of low BMD among middle-aged and older adults in the Abay region and underscores key modifiable risk factors, including older age, lower BMI, fracture history, and rheumatoid arthritis. These findings are essential for strengthening clinical diagnostic practices and guiding preventive strategies to reduce osteoporosis-related complications in the Kazakh population.

Background: Type 2 diabetes mellitus is associated with increased cardiovascular risk, with physical inactivity contributing significantly to metabolic dysfunction. This study aimed to investigate the association between physical activity status and cardiometabolic markers in patients with type 2 diabetes mellitus in the United Arab Emirates.

Methods: This cross-sectional study was conducted at Thumbay Labs, UAE, between January and October 2025. A total of 185 participants with type 2 diabetes were stratified into active (at least 150 minutes per week for more than 3 months) (n=99) and sedentary (n=86) groups based on physical activity levels. The active group was further subclassified by exercise type: aerobic (n=70), combined (n=17), and resistance training (n=11). Anthropometric measurements and biochemical parameters including fasting glucose, HbA1c, Fructosamine, fasting insulin, HOMA-IR, and lipid profile were assessed. Mann-Whitney U test, Kruskal-Wallis test, and Spearman's correlation were used for statistical analysis.

Results: The active group demonstrated significantly lower BMI (26.4 vs 28.6 kg/m², p<0.001), fasting glucose (127 vs 149 mg/dl, p<0.001), HbA1c (6.84% vs 8.07%, p<0.001), Fructosamine (303 vs 362 μmol/L, p<0.001), fasting insulin (9.03 vs 10.99 μU/mL, p=0.011), and HOMA-IR (3.0 vs 4.1, p<0.001) compared to the sedentary group. No significant differences were observed in lipid parameters. Among exercise subgroups, resistance training exhibited the most favorable metabolic profile with the lowest HbA1c (6.41%), BMI (23.01 kg/m²), and HOMA-IR (1.9). Correlation analysis revealed significant positive associations between BMI and glycemic markers as well as insulin resistance indices.

Conclusion: Physical activity is associated with significantly better glycemic control, insulin sensitivity, and body composition in patients with type 2 diabetes. Resistance training demonstrated particularly favorable metabolic outcomes; however, limited sample size restrict generalizability. These findings support the integration of regular physical activity into comprehensive diabetes care strategies.