№2 (2025)

Introduction. Air pollution with fine particulate matter (PM₂,₅) is a factor
exerting a significant impact on human health and the environment. In
Bishkek, air quality deteriorates during the autumn–winter season due to
fuel combustion, industrial emissions, transportation, and temperature inversions.
Objective. To assess the impact of PM₂,₅ concentrations on morbidity and
mortality from cardiovascular diseases (ICD-10: I00–I99) and respiratory
diseases (ICD-10: J00–J99) among the population of Bishkek, Kyrgyz Republic, over a ten-year period.
Materials and Methods. Data on morbidity (2014–2024) and mortality
(2013–2023) were obtained from the Center of Electronic Health of the Ministry of Health of the Kyrgyz Republic, classified according to ICD-10: cardiovascular diseases (I00–I99) and respiratory diseases (J00–J99). Indicators
were standardized per 100,000 population. Data from Kyrgyzhydromet on
average daily PM₂,₅ concentrations in the ambient air of Bishkek for 2023–
2024 were analyzed. Statistical and descriptive epidemiological methods
were applied.
Results and Discussion. In 2024, compared with 2014, morbidity from cardiovascular diseases decreased by 29.5% nationwide and by 43.7% in
Bishkek. Morbidity from respiratory diseases over ten years declined by
1.3% nationwide and by 21.2% in Bishkek. However, morbidity from respiratory diseases in Bishkek exceeded national rates by 1.9–2.3 times. Over
the ten-year period, mortality from cardiovascular diseases decreased by
24.5% nationwide and by 28.2% in Bishkek. Mortality from respiratory diseases declined by 26.6% nationwide, but in Bishkek an increase of 42.6%
was observed (primarily due to pneumonia). A strong positive correlation
was identified between PM₂,₅ pollution and respiratory disease morbidity (r ≈ +0.91).
Conclusion. Air pollution with PM₂,₅ has a negative impact on the health of
Bishkek residents. Annual mean concentrations of PM₂,₅ (30–38 µg/m³) exceeded the maximum permissible level established in the Kyrgyz Republic
by 1.2–1.5 times. The peak incidence of respiratory diseases (asthma,
chronic obstructive pulmonary disease, pneumonia) occurred in winter.

Introduction. In the context of globalization and scientific-technological
progress, research publication is a key indicator of a country’s scientific capacity, especially in the field of medicine. The I.K. Akhunbaev Kyrgyz State
Medical Academy (KSMA) is among the leading institutions in the Kyrgyz
Republic in terms of scientific output. Given the recent increase in the number of publications, a comprehensive bibliometric analysis is needed to evaluate the Academy’s contribution to national science.
Objective. To conduct a bibliometric analysis of the publication activity of
KSMA based on data from the Scopus database and to assess its contribution
to the development of the country's scientific potential.
Materials and Methods. The study was based on bibliometric methods using
data from the Scopus database. Article selection followed the PRISMA flow
diagram. A total of 567 peer-reviewed articles were included in the analysis.
Descriptive statistics were performed using Microsoft Excel.
Results. As of June 6, 2025, Scopus listed 628 publications affiliated with
KSMA. There is a steady growth in output, from 111 publications in 2020
to 164 in 2024. Over 90% of the publications are original research articles
and reviews. About 15% were published in high-impact international journals such as The Lancet, Nature, and NEJM. The total number of citations
reached 128,951, averaging 206.7 citations per article. Funding was acknowledged in 184 publications (29.3%), mainly from international donors
such as the Bill & Melinda Gates Foundation and the NIH, with minimal
national funding.
Conclusion. KSMA holds a leading position in medical science in Kyrgyzstan. The high proportion of original studies and publications in top-tier journals confirms its significant role in advancing biomedical research.
However, limited domestic funding highlights the need for increased governmental support. The findings underscore the importance of a systematic
approach to fostering scientific activity and the relevance of bibliometric
monitoring for assessing institutional contributions to national and global
scientific progress.

Introduction. Publication activity is an important indicator of the scientific and educational potential of a university, especially in medicine. According to the Scopus bibliometric database, the Kyrgyz State Medical Academy named after I.K. Akhunbaev (KSMA) is the leader among medical universities in the country in terms of the number and citation of publications. However, the intellectual structure of KSMA publications and its evolution over time, as well as the contribution of KSMA staff research to solving problems related to the UN Sustainable Development Goals (SDGs) have not been studied to date.
Objective: To study the evolution of the intellectual structure of KSMA publications in recent years and assess their connection with the achievement of the SDGs.
Materials and methods. The analysis was performed based on KSMA publications in Scopus as of June 6, 2025. Visualization methods using the VOSviewer program were used to highlight thematic areas, keywords, and trends. The connections of publications to the UN SDGs was analyzed based on Scopus data.
Results. As of June 6, 2025, 628 KSMA publications were registered in Scopus. The visualization revealed seven thematic clusters of publications, the largest of which were epidemiology of the main NCDs in Central Asian countries (including Kyrgyzstan and Kazakhstan); cardiovascular and metabolic diseases, kidney diseases; problems of high-altitude hypoxia and high-altitude medicine; and, since 2020, studies related to the COVID-19 pandemic. The vast majority of KSMA publications are related to the achievement of SDG 3 “Ensure healthy lives and promote well-being for all at all ages”, which is essential for achieving all other UN SDGs.
Conclusion. According to the Scopus database, the intellectual structure of the research of KSMA employees covers a large number of scientific areas, which are combined into several clusters. A cluster of publications on high-mountain physiology and medicine is typical for Kyrgyzstan. Publications of KSMA scientists are mainly related to solving problems aimed at achieving the UN SDG 3. A comprehensive analysis of the publication activity of KSMA based on data from other bibliometric databases, including the RSCI database, is relevant.

Introduction. Eye injury accounts for approximately 3% of all emergency
department visits. Knowledge of potential eye injuries and their correlations
with imaging is essential for accurate and rapid diagnosis of post-traumatic
orbital injury.
The purpose of the work. Analysis of epidemiological characteristics of patients with eye injuries who require urgent surgical intervention. A secondary
goal is to identify the factors influencing the final visual result.
Research materials and methods. During 10 years and 4 months, a total of
92 patients were examined, of which 59.8% (n=55) were men and 40.2%
(n=37) were women. The average age was 54.76±22.18 years, and the average age of women (64.38±22.90 years) was higher than that of men
(48.29±19.33 years, P<0.05). A total of 35.13% of patients (n=32) from the
sample were over 65 years of age. The incidence rate was 1.45 cases per
100,000 inhabitants per year.
Results and discussion. The most common cause of eye injury was domestic
accidents (44.6%), followed by assaults (22.8%) and industrial accidents
(17.4%). Of the domestic accidents, 61% occurred in patients over 65 years
of age (P<0.001), assault injuries were sustained in 66.7% of cases in the
youngest group of patients (P<0.001), and industrial accidents were more
common in the 15-45 age group (50%; P<0.001). As for gender, injuries
sustained at home were more common in women (53.7%; female to male
ratio=1.16:1, P=0.011), while assault injuries were more common in men
(85.7%; male to female ratio=6:1, P=0.006).
Conclusion. Research shows that the causes of eye injuries requiring surgery
vary depending on gender and age. The data obtained confirm the opinion
that the nature of eye injuries in the region reflects the socio-economic status
of its inhabitants.

Introduction. A special place is occupied by the problems of proper diagnosis
of neurosurgical diseases.
The purpose of the study is to analyze modern theoretical and methodological approaches to the study of the brain in its various lesions.
Materials and methods. Available full-text Russian and English-language
articles from the scientific citation databases of the Russian Science Citation
Index and Scopus, as well as monographs on this topic.
Results and discussions. It shows how diagnosis and surgical treatment are
practically implemented through clinical thinking. A special place in the article was given to the problems of proper diagnosis of neurosurgical diseases.
Conclusion. The article substantiates the exceptional importance of a creative approach in making a diagnosis and the role of a neurosurgeon as a
creator in deciding on the expediency and timeliness of surgical treatment,
primarily of the patient himself, rather than the disease.

Introduction. Pertussis outbreaks among children have been observed in recent years worldwide, despite the successful implementation of vaccination
programs. In the Kyrgyz Republic, an increase in pertussis incidence has
been recorded over the past three years. It was therefore decided to study the
involvement of children in the epidemic process in the country.
Objective of the study. Study of Pertussis Incidence Among Children Under
14 Years of Age by Region in the Kyrgyz Republic, 2014–2024
Materials and methods. To calculate incidence rates per 100,000 population,
data from the national reporting form No. 1 "Report on Infectious and Parasitic Diseases" for the period 2014–2024 were used. Population data for the
Kyrgyz Republic by region were obtained from the sources of the National
Statistical Committee.
Results and discussion. Based on the average annual pertussis incidence
among children under 14 years of age for the period 2014–2024, the territory
of the Kyrgyz Republic can be conditionally divided into three zones: epidemiologically unfavorable – Bishkek city and Chuy region (1560∕0000 and
650∕0000, respectively), medium incidence level – Talas (11,7 0∕0 000) IssykKul (8,00∕0 000), and Naryn (5,50∕0 000) regions, low incidence level – Osh
city (3,10∕0 000), Jalal-Abad (1,90∕0 000), Batken (0,50∕0 000), and Osh
(0,30∕0 000) regions. Over the past ten years, three outbreaks were recorded
in all regions — in 2015, 2018, and 2024 — with incidence rates of 14,80∕0
000, 29,60∕0 000, and 143,50∕0 000, respectively. The most intense was the
latest surge, which is likely associated with an increasing proportion of unimmunized children, waning post-vaccination immunity, and other contributing
factors.
Conclusion. Epidemic heterogeneity, marked by a wide range of average annual incidence rates, necessitates further evaluation of the surveillance system, risk factors, and other determinants at the regional level.
The progressive increase in pertussis incidence during the period 2022–2024
underscores the need to conduct molecular characterization of the pathogen
to assess the concordance between circulating Bordetella pertussis strains
and vaccine strains.
A comparative analysis of age-related susceptibility of children to pertussis
has been conducted, the results of which are presented in the continuation
of this publication entitled: “Analysis of Age-related Susceptibility of Children to Pertussis by Region in the Kyrgyz Republic, 2014–2024.”

Introduction. Waterborne infectious diseases remain one of the key public
health challenges.
Objective. To assess the microbiological quality of water and identify prevalent strains of bacteria resistant to antimicrobial agents (AMR). To evaluate
the antibiotic susceptibility of the isolated strains.
Materials and Methods. Bacteriological techniques, including titration methods, were used in this study. Water samples were collected according to ISO
19458:2009: Water quality- Sampling for microbiological analysis, following biosafety protocols. Laboratory data interpretation was carried out in accordance with National Guideline Order No. 576 dated June 28, 2017,
“Sanitary-Bacteriological Monitoring of Surface Water”.
Results. From 2013 to 2022, 113 water samples were analyzed in Bishkek, of which 40.7% did not meet hygienic standards. In 2024, 82 additional
water samples were examined; all showed mixed infections caused by conditionally pathogenic Enterobacterales bacteria, including E.coli, Proteus,
and Enterobacter. The susceptibility of E.coli to antibiotics ranged from
35% (amoxicillin-clavulanic acid) to 70% (meropenem).
Conclusion. The conducted study confirmed the high level of microbiological contamination in surface and wastewater of Bishkek and revealed the presence of bacteria resistant to antimicrobial agents (AMR).

Introduction. The health of young people is a key value that is influenced
by lifestyle, the body's adaptive capabilities and modern habits, including
the use of energy drinks.
The aim of the study is to assess the impact of the main components of
lifestyle, including energy drinks, on the health of students.
Material and methods. An analysis of medical questionnaires of students
aged 18–25 was conducted, assessing nutrition, physical activity and the use
of energy drinks.
Results and discussion. 48% of students eat irregularly and consume energy
drinks, 35% - alcohol, which negatively affects the health and adaptive capabilities of young people.
Conclusion. The formation of a healthy lifestyle and the prevention of bad
habits, including the use of energy drinks, are necessary to maintain the
health of young people.

Introduction. This study analyzes the state of outpatient pediatric care in the Kyrgyz Republic, using the example of the Consultative and Diagnostic Department (CDD) of the National Center for Maternal and Child Health (NCMCH). The aim is to scientifically analyze the dynamics of patient visits and the structure of childhood diseases, and subsequently propose a program to improve the outpatient care system. The relevance of the study is driven by the
need to optimize medical services for children in the context of active digitalization of healthcare in the Kyrgyz Republic, which aims to enhance the
efficiency, accessibility, and quality of medical care. Methods. The study was retrospective, descriptive, and analytical, based on
data from the NCMCH CDD for the period 2021–2024. The analysis included medical records, data from the electronic information system, outpatient reception logs, and reports on consultations, hospitalizations, and
referrals. Descriptive and systemic statistical methods were used to evaluate the dynamics of visits, the age and regional structure of patients, and the effectiveness of the CDD's work. The statistical significance of differences
was determined at p<0.05. Results. A total of 439,516 children were consulted at the NCMCH CDD between 2021 and 2024. A decrease in the total number of visits has been observed since 2022. The number of patients presenting without a referral decreased by half, from 20.4% in 2021 to 11.3% in 2024, which is associated
with the implementation of electronic appointment scheduling and improved
patient sorting. The majority of patients were residents of the Chui region (35.61%) and Bishkek city (22.15%). The age structure showed that until 2024, children under 6 predominated. In 2024, 61.9% of patients were referred back to Primary Health Care (PHC), 24% remained under observation at the CDD, and 10% were hospitalized. A high workload on narrow-specialty doctors (ranging from 101% to 283%) was noted, confirming a staffing shortage.
Conclusion. The introduction of electronic technologies, such as online appointments, contributed to a reduction in unreferred visits and an increase in operational efficiency. However, challenges persist, including the uneven
distribution of workload among specialists, a shortage of PHC staff, and the
concentration of patients from nearby regions. To improve the pediatric outpatient care system, a program is proposed that includes: 1) further development and integration of digital platforms to enhance coordination between
healthcare levels; 2) optimization of patient logistics and routing; 3) creation
of a centralized information portal for parents; 4) expanded use of telemedicine consultations to alleviate the burden on specialized doctors.

Introduction. The COVID-19 pandemic posed a challenge to the healthcare system of the Kyrgyz Republic, requiring the rapid allocation of limited resources through mathematical modeling.
The objective of this research is to demonstrate that three-scenario shortterm forecasting using the ARIMA model allows for advance estimation of expected COVID-19 incidence under various management interventions. Methods. The study used official daily COVID-19 incidence data for the Kyrgyz Republic from 2020 to 2023. Daily reproduction numbers (R) were calculated in R (version 4.3.2) using the EpiEstim package and subsequently integrated into an autoregressive integrated moving average (ARIMA)
model, generating a 15-day forecast. Three scenarios were developed to account for potential changes in non-pharmaceutical interventions: (1) Optimistic scenario — a 10% reduction in R (strengthened restrictions, active vaccination); (2) Baseline scenario — R equal to the average value over the previous five days; (3) Pessimistic scenario — a 10% increase in R (relaxed measures, circulation of a more transmissible variant). Results. For the period of April 5–19, 2021, the model predicted between 232 and 350 new cases by April 19; the actual number (299) fell within this predictive interval, confirming the validity of the approach. The mean absolute percentage error did not exceed 10%. Conclusion. Thus, the proposed three-scenario tool provides healthcare organizations with approximately a two-week planning horizon for resource allocation and adjustment of epidemic control strategies oriented toward the
worst-case scenario.

Introduction. The introduction of artificial intelligence (AI) technologies
into the healthcare system is accompanied not only by new opportunities
but also by risks of harm, including algorithm errors that can affect patients'
lives and health. Shortcomings in the ethical and legal regulation of responsibility when using AI in healthcare in the national context can become a
barrier to the country's digital transformation.
Purpose of the study. To explore the ethical and legal challenges of AI in
healthcare in the Kyrgyz Republic and develop recommendations to ensure
its responsible use, taking into account the national context of the country's
digitalization.
Materials and methods. Analytical review of regulations, international ethical guidelines in the field of AI and digital healthcare.
Results. The introduction of AI technologies in healthcare is uneven. Health care workers feel lost in new AI systems, as they are not trained to work
with digital platforms. Due to the lack of centralized repositories, medical
information is scattered, and AI cannot “learn” effectively; problems of trust
in AI systems on the part of doctors arise. Ethical aspects of AI use in the
country remain outside the focus of academic and applied research; there
are no systematic reviews or empirical data on this issue in the public domain. There is no single law on digitalization and artificial intelligence in
Kyrgyzstan either. The country does not provide for a classification of risks
for AI-based medical systems. Issues of moral and legal responsibility for
AI mistakes that lead to medical errors are not regulated in the country. Responsibility for AI errors in healthcare should be multi-layered. Physicians
retain professional responsibility for clinical decisions. AI developers are
required to ensure the quality of algorithms. Medical organizations must
create conditions for the safe use of technologies.
Conclusion. Ethical and legal issues of AI use can become a challenge for
the digitalization of the Kyrgyz Republic. The use of AI in medicine requires
an ethical and legal framework that clearly delineates the areas of responsibility of all participants, increasing the trust of doctors and patients in AI
and their motivation to use AI

Introduction. According to WHO data, healthcare workers are inevitably
exposed to the highest risk of infection during pandemics.
The aim of this study was to identify the epidemiological features of
COVID-19 spread among healthcare workers in inpatient facilities under
the Ministry of Health of the Kyrgyz Republic.
Materials and Methods. A retrospective analysis of statistical data from
2020 to 2023 and a survey of healthcare workers were conducted.
Results. Healthcare personnel on the frontlines of the pandemic were found
to be at significant risk of infection, with morbidity rates during peak months
exceeding those of the general population by 4 to 13 times. Four epidemic
waves were registered among medical personnel, each associated with the
emergence of a new SARS-CoV-2 variant (strains B, Delta, Omicron
BA.1.1). The highest number of infections among doctors was recorded in
July 2020. Nurses were identified as the most vulnerable group due to constant close contact with patients. Key risk factors identified included: insufficient respiratory personal protective equipment (PPE) — use of KN95
masks that did not provide adequate protection (FIT-test showed 0% effectiveness); violation of PPE replacement protocols (39% of respondents did
not replace respirators); presence of comorbidities (OR = 2.3); and living
in dormitories with infected colleagues (OR = 2.9).
Conclusion. The study confirms the necessity of a systematic approach to
protecting healthcare personnel — from timely and adequate provision of
respiratory PPE to strict adherence to infection control protocols. These
measures are critical to reducing occupational risks and preventing nosocomial transmission of COVID-19 in the future.

Introduction. In the context of a global shortage of health workers and increasing demands on the quality of medical services, the introduction of artificial intelligence technologies in primary health care is of strategic
importance.
The purpose of this study is to conduct a SWOT analysis of the prospects
for the introduction of artificial intelligence in primary health care in Kyrgyzstan to develop recommendations for its effective implementation.
Materials and methods. The study is based on a systematic analysis of international publications, regulations and reports of international organizations using the principles of SWOT analysis and strategic planning. The
literature review for the period 2015-2023 included publications from
PubMed, Web of Science and other databases with an emphasis on clinical
trials and meta-analyses.
Results and discussion. The SWOT analysis revealed strengths, such as government digitalization policy and a developed primary health care network,
as well as weaknesses, including limited digital infrastructure and staff
shortages. Opportunities include international cooperation and the development of epidemiological surveillance, while threats are associated with cybersecurity risks and insufficient funding.
Conclusion. The results show that the implementation of artificial intelligence in primary health care in Kyrgyzstan can improve the quality and accessibility of health services. However, existing limitations such as staff
shortages and inadequate regulatory framework need to be overcome. Successful integration of artificial intelligence in primary health care requires
a comprehensive government approach, including full funding, development
of a regulatory framework, digital infrastructure, and staff training. Further
research should focus on assessing the effectiveness of artificial intelligence
in real clinical practice.

Introduction. Medical waste (MW) is an integral byproduct of healthcare
systems. With the increasing volume of MW caused by the introduction of
new medical technologies and the consequences of the COVID-19 pandemic, its safe and effective management has gained strategic importance
for public health, environmental safety, and sustainable development.
Objective. To conduct a systematic analysis of classification, treatment, and disposal approaches for MW, focusing on the applicability of technologies
in the context of the Kyrgyz Republic, and to identify key barriers and development prospects.
Materials and Methods. An analytical review of scientific and regulatory
literature was conducted, including WHO guidelines, EU directives, the provisions of the Basel Convention, and national standards of the Kyrgyz Republic and the Russian Federation. Five treatment technologies were
evaluated based on four criteria: disinfection efficiency, environmental
safety, cost-effectiveness, and applicability under resource-limited conditions. Up to 15% of MW is classified as hazardous. The most widely used
technologies include autoclaving, incineration, microwave disinfection, pyrolysis, and mechanical-biological methods. In Kyrgyzstan, the key limitations identified were: only 23% of healthcare facilities are equipped with
certified treatment units, fewer than half of personnel are trained, and infrastructure and interagency coordination are underdeveloped.
Conclusion. The development of a MW management system requires the
implementation of digital solutions (blockchain, RFID), biodegradable
packaging, mobile treatment units, recycling programs, and the establishment of a national monitoring center. The presented materials can serve as
a basis for developing strategic documents, educational programs, and project initiatives in the field of MW management.

Introduction. Hypoxia is a pressing issue associated with oxygen deficiency
and requiring study of the body's adaptation mechanisms.
The aim of the study is to summarize current data on the mechanisms of
adaptation to hypoxia to improve understanding and increase resistance to
it.
Materials and methods. A comparative analysis of scientific literature on
the adaptation of organs and systems to hypoxia was conducted.
Results and discussion. Key pathophysiological mechanisms were identified
and the need for further research for effective prevention and therapy of hypoxic conditions was noted.
Conclusion. The review identified the main directions and gaps in the study
of adaptation to hypoxia, which is important for the development of new
approaches to overcoming it.